Abstract: Objective To explore the correlation between recurrent respiratory tract infections(RRTI) and immunoglobulin and IgG subtypes in children. Methods According to diagnostic criteria of RRTI,80 cases of children group and 60 cases of control group of different age diagnosed with RRTI were collected from March 2014 to March 2015,and the levels of immunoglobulin (IgG,IgA,IgM)and IgG subtypes (G1,G2,G3,G4) in serum were detected. Results Compared with normal group:in 0 to 2 years old children group,the levels of IgG,IgA and IgM had no obvious differences (P>0.05),the level of IgG4 decreased significantly (P<0.05);In 3 to 5 years old children group,the levels of IgG and IgM had no significant differences (P>0.05),the level of IgA decreased obviously (P<0.05),the levels of IgG2 and IgG4 decreased significantly (P<0.05);In 6 to 12 years old children group,the levels of IgG,IgA and IgM had no obvious differences (P>0.05),the levels of IgG1,IgG2,IgG3 and IgG4 had no significant differences (P>0.05).And as children age,the levels of IgG and IgA had obvious growth trend,the level of IgM changed little.There were defects of IgG subtypes in children with RRTI,the detection rate of 42.5%,individual defects was given priority to with IgG4 accounted for 35%,joint defect was given priority to with IgG2 and IgG4 accounted for 41%. Conclusions There are defects of immunoglobulin IgG subtypes in RRTI of children.The class testing of IgG subtypes should be attached in clinical,the defects in IgG2 and IgG4 may be one of the causes of RRTI in children,which is more sensitive to reflect the immune function of children with RRTI.

Key words: recurrent respiratory tract infections, immunoglobulin, IgG subtypes

摘要： 目的 分析儿童反复呼吸道感染(recurrent respiratory tract infections,RRTI)与免疫球蛋白(Ig)及IgG亚类的相关性。方法 依据RRTI的诊断标准,收集本院2014年3月-2015年3月诊断为RRTI的患儿组80例和不同年龄对照组60例,检测血清免疫球蛋白(IgG、IgA、IgM)和 IgG 亚类(G1、G2、G3、G4)。结果 各年龄组患儿与正常组相比,0~2岁患儿:IgG、IgA、IgM差异无统计学意义(P＞0.05),IgG4明显降低(P＜0.05);3~5岁患儿:IgG、IgM差异无统计学意义(P＞0.05),IgA明显降低(P＜0.05),IgG2 、IgG4明显降低(P＜0.05);6~12岁患儿:IgG、IgA、IgM差异无统计学意义(P＞0.05),IgG1、IgG2、IgG3、IgG4差异无统计学意义(P＞0.05)。且随着年龄增长IgG、IgA有明显增长的趋势,IgM变化不明显。RRTI儿童存在IgG亚类缺陷,检出率42.5%,其中单项缺陷以IgG4为主占35%,联合缺陷以IgG2、IgG4为主占41%。结论 RRTI儿童存在免疫球蛋白IgG亚类缺陷,临床应重视IgG亚类检测,IgG2 、IgG4缺陷可能是儿童RRTI的发病原因之一,它能更敏感地反映RRTI患儿的免疫功能。

关键词: 反复呼吸道感染, 免疫球蛋白, IgG亚类