2025 年第 6 期 第 20 卷

辅助性T细胞1/2细胞因子在人偏肺病毒感染患儿中的表达及其在哮喘发病中的作用

Expression of T helper cell 1/2 cytokines in children with human metapenu-movirus induced infection and its role in the pathogenesis of asthma

作者：孙伟1周亮1张蕾1周建伟2闫智慧3董伟然1

英文作者：Sun Wei1 Zhou Liang1 Zhang Lei1 Zhou Jianwei2 Yan Zhihui3 Dong Weiran1

单位：1河北省儿童医院呼吸四科河北省儿童健康与疾病临床医学研究中心河北省医学重点学科儿科国家临床重点专科，石家庄050000；2河北省石家庄市人民医院骨科，石家庄050000；3河北省儿童医院呼吸一科，石家庄050000

英文单位：1The Fourth Department of Respiratory Hebei Children′s Hospital Hebei Provincial Clinical Research Center for Child Health and Disease Hebei Provincial Medical Key Discipline National Key Clinical Specialty of Pediatrics Shijiazhuang 050000 China; 2Department of Orthopedics Shijiazhuang People′s Hospital Hebei Province Shijiazhuang 050000 China; 3the First Department of Respiratory Hebei Children′s Hospital Shijiazhuang 050000 China

关键词：人偏肺病毒感染；病毒感染；辅助性T细胞1/2细胞因子；哮喘

英文关键词：Humanmetapneumovirusinfection;Virusinfection;Thelpercell1/2cytokines;Asthma

• 摘要：

• 目的 探究辅助性T细胞1（Th1）/Th2细胞因子在人偏肺病毒（hMPV）感染患儿中的表达变化及其在哮喘发病中的作用。方法 回顾性分析2023年2月至2024年3月于河北省儿童医院就诊的hMPV感染患儿245例的临床资料，根据患儿病情严重程度分为轻症组（170例）和重症组（75例）。收集患儿一般资料，检测患儿气道炎症指标、肺功能指标及Th1/Th2细胞因子水平。使用多元线性回归模型分析Th1/Th2细胞因子水平与气道炎症因子水平的相关性；采用二元Logistic回归模型分析影响hMPV感染患儿发生哮喘的相关危险因素。结果 重症组肿瘤坏死因子α（TNF-α）、白细胞介素4（IL-4）、IL-6、CD+8 T淋巴细胞水平均高于轻症组，IL-10、γ-干扰素、CD+3 T淋巴细胞、CD+4 T淋巴细胞、第1秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC比值均低于轻症组（均P<0.05）。245例患儿中，58例诊断为哮喘（哮喘组）、187例无哮喘（非哮喘组）。哮喘组TNF-α、IL-4、IL-6、CD+8 T淋巴细胞水平均明显高于非哮喘组，IL-10、γ-干扰素、CD+3 T淋巴细胞、CD+4 T淋巴细胞、FEV1、FVC、FEV1/FVC比值均低于非哮喘组（均P<0.05）。二元Logistic回归模分析结果显示，较高的TNF-α、IL-4、IL-6及CD+8 T淋巴细胞水平，较低的IL-10、γ-干扰素、CD+3 T淋巴细胞、CD+4 T淋巴细胞、FEV1、FVC、FEV1/FVC比值水平均为影响hMPV感染患儿发生哮喘的独立危险因素（均P＜0.05）。CD+3 T淋巴细胞与IL-4、IL-6呈负相关，CD+4 T淋巴细胞与IL-6呈负相关、与IL-10呈正相关，CD+8 T淋巴细胞与IL-4、IL-6呈正相关，与IL-10呈负相关（均P<0.05）。结论 发生哮喘的hMPV感染患儿Th1/Th2细胞因子水平存在更为明显的异常变化，且Th1/Th2细胞因子水平与患儿疾病严重程度密切相关，临床可通过检测Th1/Th2细胞因子水平对hMPV感染患儿哮喘发作进行预测。

• Objective To investigate the expression of T helper cell 1 (Th1) /Th2 cytokines in children with human metapenu-movirus (hMPV) induced infection and its role in the pathogenesis of asthma. Methods The clinical data of 245 children with hMPV induced infection who were admitted to Hebei Children′s Hospital from February 2023 to March 2024 were retrospectively analyzed. According to the severity of the disease, the children were divided into mild group (170 cases) and severe group (75 cases). The general data of the children were collected, and airway inflammation indicators, lung function indicators and Th1/Th2 cytokine levels were detected. Multiple linear regression model was used to analyze the correlation between Th1/Th2 cytokine levels and airway inflammatory factors. Binary Logistic regression model was used to analyze the risk factors for asthma in children with hMPV infection. Results The levels of tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), IL-6 and CD+8 T lymphocytes in the severe group were higher than those in the mild group, and the levels of IL-10, γ-interferon, CD+3 T lymphocytes, CD+4 T lymphocytes, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio in the severe group were lower than those in the mild group (all P<0.05）. Among the 245 children, 58 were diagnosed with asthma (asthma group) and 187 without asthma (non-asthma group). The levels of TNF-α, IL-4, IL-6 and CD+8 T lymphocytes in the asthma group were significantly higher than those in the non-asthma group, and the levels of IL-10, γ-interferon, CD+3 T lymphocytes, CD+4 T lymphocytes, FEV1, FVC and FEV1/FVC ratios in the asthma group were lower than those in the non-asthma group (all P<0.05）. The results  of binary logistic regression model analysis showed that higher levels of TNF-α, IL-4, IL-6 and CD+8 T lymphocytes, and lower levels of IL-10, γ-interferon, CD+3 T lymphocytes, CD+4 T lymphocytes, FEV1, FVC and FEV1/FVC ratios were independent risk factors for asthma in children with hMPV infection (all P<0.05). CD+3 T lymphocytes were negatively correlated with IL-4 and IL-6, CD+4 T lymphocytes were negatively correlated with IL-6 and positively correlated with IL-10, and CD+8 T lymphocytes were positively correlated with IL-4 and IL-6 and negatively correlated with IL-10 (all P<0.05). Conclusion There are more obvious abnormal changes in Th1/Th2 cytokine levels in children with asthma caused by hMPV induced infection, and the levels of Th1/Th2 cytokines are closely related to the severity of the disease in children. The detection of Th1/Th2 cytokine levels can be used to predict the attack of asthma in children with hMPV induced infection.