肾综合征出血热患者血NK活性、β_2－m、IL－2的变化及意义

SignificanceofchangesofNKactivity,β2┐m,IL┐2inthebloodofpatientswithHFRS

为了解肾综合征出血热（ＨＦＲＳ）时自然杀伤细胞（ＮＫ）活性及其相关因素的变化，采用ＭＴＴ法、ＥＬＩＳＡ法和放射免疫分析法分别检测４０例患者不同病期血中ＮＫ活性，β２－ｍ和ＩＬ－２。结果显示，ＮＫ活性在发热期（５２．８１±１０．８９），低血压少尿期（５８．０２±１３．７０）比正常值（４７．６６±６．３９）明显增高（分别为Ｐ＜０．０５，Ｐ＜０．００５）；多尿期（４３．３４±７．７０）和恢复期（５０．２３±９．４６）逐渐下降并回复正常（均为Ｐ＞０．０５）。重危型患者ＮＫ活性在病初增高程度比轻中型患者更大（Ｐ＜０．０５）。血β２－ｍ在发热期（６．８４±２．３６），低血压少尿期（８．２０±３．０４）和多尿期（４．９３±２．７２）均显著高于正常值（１．８０±０．０６）（Ｐ＜０．０５）。在少尿期，ＮＫ活性与β２－ｍ呈直线正相关（Ｐ＜０．０５）。血ＩＬ－２（１５．６３±４．１５）与正常值（１４．５±６．９９）相比无明显改变（Ｐ＞０．０５）；与ＮＫ活性也无相关性（Ｐ＞０．０５）。这表明，ＨＦＲＳ时血ＮＫ活性和β２－ｍ可能参与发病机制；它们的相关性暗示ＭＨＣ－１类分子在激活ＮＫ中的可能作用。在该病中，未观察到ＩＬ－２与ＮＫ活性?

InordertostudythechangeofNKactivityanditsassociatedfactorsinpatientswithHFRS,weinvestigatedNKactivity,IL-2andβ2-mlevelinthebloodof40casesindifferentstagesusingmethodswithMTT,ELISAandradioimmunoassayrespectively.Incomparisonwithnormalvalue(47.66±6.39),theresultsshowedthatNKactivitiesincreasedremarkablyinfebrile(52.81±10.89),hypotensiveandoliguric(58.02±13.70)phases(P<0.05,P<0.005,respectively)whereasdecreasedgradualytonormalduringdiuretic(43.34±7.70)andconvalescent(50.23±9.46)phases(P>0.05respectively).Attheearlystageofthedisease,theincreasedegreeofNKactivitywasmuchhigherinseverecasesthanthatinmoderateormildcases(P<0.05).Thevalueofbloodβ2-mwasalsosignificantlyelevatedinfebrile(6.84±2.36),hypotensiveandoliguric(8.20±3.04)aswelasdiuretic(4.93±2.72)phases(P<0.05respectively).Therewasapositivelin-earcorrelationbetweenNKactivityandβ2-minoliguricphase(P<0.05).ThevalueofbloodIL-2(15.63±4.15)displayedneitherremarkablechange(P>0.05)norcorelationwithNKactivity.ThestudyindicatedthatthechangesinNKactivityandβ2-mmightparticipateinpathogenesisofHFRS.ThecorelationbetweenthemimpliedtheprobableroleofMHC-1moleculeintriggeringNKactivityinHFRS.ThestimulationofIL-2onNKfunctionwasnotobservedinthisdisease.