小儿全身炎症反应综合征血LPS、TNF-α、IL-10水平和IL-10/TNF-α比值的变化及其临床意义

The change and clinical significance of LPS,TNF-α,IL-10 and IL-10/ TNF-α ratio in children with systemic inflammatory response syndrome

目的比较全身炎症反应综合征(SIRS)患儿与健康儿童血内毒素(LPS)、肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)水平以及动态观察IL-10在SIRS发展过程中的变化。方法将SIRS患儿58例设为SIRS组,另21例健康儿童为对照组,分别采用鲎试剂动态比浊定量测定法、酶联免疫实验进行血LPS、TNF-α、IL-10的定量测定,计算IL-10/TNF-α比值,并对部分患儿进行IL-10和IL-10/TNF-α动态观察。结果SIRS组LPS、TNF-α、IL-10的水平均明显高于对照组(P<0.01),且TNF-α与IL-10的浓度随LPS水平升高而升高,2者呈显著正相关(P<0.05)。血LPS、IL-10以及IL-10/TNF-α在病情恶化或死亡的病例中高于治愈或好转病例(P<0.05)。结论LPS、TNF-α、IL-10的水平与IL-10/TNF-α比值的高低与SIRS预后有关。

Objective To detect the levels of LPS, TNF-α and IL-10 in children with systemic inflammatory response syndrome （SIRS） and compare them with healthy children, and to observe the changes of concentration of TNF-α and IL-10 and to clarify the role of LPS, TNF-α and IL-10 in pathogenesis of SIRS. Methods LPS was determined by limulus reagent kinetic turbidimetric assay, and TNF-α and IL-10 were detected by ELISA method. At the same time IL-10/TNF-α ratio was calculated. The levels of TNF-α and IL-10/TNF-α ratio were dynamiclly observed in part of patients.Results the levels of LPS, TNF-α and IL-10 in SIRS group were significantly higher than those in healthy children （ P 〈 0.01 ）. With the increase of concentration of LPS, the levels of TNF-α and IL-10 were increased accordingly, which showed a positive correlation between them（ P 〈0.05）. The levels of serum LPS, IL-10 and IL-10/ TNF-α ratio were significantly increased in patients with severe condition and death cases（ P 〈 0.01）. Conclusion The levels of LPS, TNF-α and IL- 10 are closely related with the prognosis of SIRS.