摘要
摘要目的观察不同程度小儿肺炎时，血清致炎性细胞因子肿瘤坏死因子（TNFα）、白细胞介素6和8（IL-6、IL-8）的动态变化及其临床意义。方法对2002—2003年杭州市中医院儿科收治的肺炎患儿74例，根据病情轻重将患儿分为重症肺炎组（51例）、非重症肺炎组（23例）。采用ELISA法测定治疗前后的血清TNFα、IL-6、IL-8的动态变化。同步测定两组治疗前后的血C反应蛋白和血白细胞总数的动态变化。结果重症肺炎患儿的血清TNFα（55．94±28．99pg／ml）、IL-6（151．60、±68．75pg／ml）、IL-8（39．09±16．97pg／ml）浓度明显高于非重症肺炎患儿的血清TNFα（13．96±8．01pg／ml）、IL-6（33．76±17．16pg／ml）和IL-8（7．74±3．34pg／ml），两组之间的差异有非常显著意义（P〈0．01）。治疗后，重症肺炎组的血清TNFd（18．08±7．26pg／ml）、IL-6（11．95±5．11pg／ml）、IL-8（5．81±2．64pg／ml）水平较治疗前明显下降，治疗前后比较差异有非常显著意义（P〈0．01），非重症肺炎患儿的血清TNFot（8．49±4．72pg／ml）、IL-6（8．3±3．31pg／ml）水平较治疗前有明显下降，差异有非常显著意义（P〈0．01），而IL-8（6．74±2．51pg／ml）的浓度变化其差异无显著性（P〉0．05）。血清C反应蛋白（CRP）和血白细胞总数呈相似的变化，重症肺炎组患儿血CRP（40．18±18．83mg／L）和白细胞总数[（11．883±4．553）×10^9／L]均高于非重症肺炎组CRP（8．21±5．51mg／L）和白细胞总数[（8．850±2．492）×10^9／L）。治疗后重症肺炎组血CRP仍高于非重症肺炎组（P〈0．01），血白细胞总数在两组间差异无显著意义。结论在小儿肺炎的发病过程中，存在着致炎性细胞因子TNFα、IL-6、IL-8的过度释放。TNFα、IL-6、IL-8可作为反映肺炎严重程度的监测指标。
Objective To explore the changes and clinical significance of inflammatory cytokines tumor necrosis factor alpha（α） and interleukin IL - 6 IL - 8 in severe pneumonia in children. Methods By using enzyme - linked immunosorbent assay（ELISA） method, serum TNFα .IL- 6 and IL- 8 concentrations were measured in 74 pneumonia children treated between 2002 to 2003 in pedritrics. Among them 51 children were severe and 23 children were mild.Serum C -reactive protein（CRP） and blood leucocyte were measured simuhaneously in 74 patients before and after treatment. Results In severe pneumonia group, the concentrations of serum TNFα, IL - 6 and IL - 8 were 55.94 ± 28.99pg/Ml 151.60 ± 68.75pg/ml, and 39.09 ± 16.97pg/ml, respectively, were significantly higher than those in mild group, where the values were 13.96 ± 8.01pg/ml,33.76 ± 17.16pg/ml, and 7.74 ± 3.34pg/ml （ P 〈 0.01 ） , After treatment, the concentrations of serum TNFα, IL - 6 and IL - 8 declined significantly in severe group （ 18.08 ± 7.62pg/ml, 11.95 ± 5.11 pg/ml, 5.81 ± 2.64pg/ml （ P 〈 0.01 ） , and the concentration of serum TNFα （ 8.49 ± 4.72pg/ml） , IL - 6（ 8.3 ± 3.31 pg/ml） were also declined significantly in mild group （P 〈 0.01 ） , but IL- 8 was not. After treatment, the concentrations of TNFα, IL- 6 in severe group were still higher than those of in mild group （ P 〈 0.01 ）. The values of serum CRP and WBC were higher in severe group than in mild group, after treatment, they were all down significantly but the serum CRP was still higher in serere group than in mild group. Conclusions There is an excessive release of inflammatory cytokine TNFα ,IL -6and IL -8 in children with severe pneumonia, they appears to reflect the severity of pneumonia in children.
出处
《医学研究杂志》
2007年第2期74-76,共3页
Journal of Medical Research
