肾综合征出血热患者血清IL-6、尿液肿瘤坏死因子、IL-6、IL-8的检测

Serum interleukin (IL) 6, urine tumor necrosis factor, IL 6 and IL 8 levels in patients with hemorrhagic fever with renal syndrome

目的探讨细胞因子在肾综合征出血热（ＨＦＲＳ）发病中的作用。方法采用双抗体夹心ＥＬＩＳＡ法对４８例ＨＦＲＳ患者及２０例正常人血清白细胞介素（ＩＬ）－６、尿液肿瘤坏死因子（ＴＮＦ）、ＩＬ－６、ＩＬ－８进行动态检测。结果ＨＦＲＳ患者血清ＩＬ－６、尿液ＴＮＦ、ＩＬ－６、ＩＬ－８含量较对照组明显增高（Ｐ＜０．００１）；发热期已增高，低血压期继续增高，少尿期达峰值；其含量随病情加重而升高，各型间差异有显著性；血清ＩＬ－６与特异性抗体升高有明显关系，与血清β２－微球蛋白（β２－ＭＧ）、血尿素氮（ＢＵＮ）、血肌酐（Ｃｒ）均呈高度正相关；尿液ＩＬ－６与ＴＮＦ、ＩＬ－８呈显著正相关（ｒ＝０．５６２１，Ｐ＜０．００５；ｒ＝０．３８４５，Ｐ＜０．０１）。结论ＨＦＲＳ患者病程中ＴＮＦ、ＩＬ－６、ＩＬ－８均处于高活性状态，ＩＬ－６与体液免疫反应亢进所致的免疫病理损伤有关，ＩＬ－６、ＩＬ－８、ＴＮＦ参与肾脏的免疫损伤，可作为判定患者预后和转归的指标。

Objective To explore the role of cellular factors in the pathogenesis of hemorrhagic fever with renal syndrome (HFRS). Methods Double antibody sandwich ELISA was used to determine serum interleukin (IL) 6, urine tumor necrosis factor (TNF), IL 6 and IL 8 levels from 48 patients with HFRS. Results Serum IL 6, urine TNF, IL 6 and IL 8 concentrations in HFRS patients were significantly higher than in controls ( P <0.001), and those in HFRS patients increased at fever stage, then continued to increase during hypotension stage and peaked at oliguria stage. The concentrations of serum IL 6, urine TNF, IL 6 and IL 8 increased in accord with the severities of the disease and differred greatly among different types of the disease. Serum IL 6 levels have remarkable relationships with the serum specific antibodies, and it was positively related to the serum β 2 microglobulin (β 2 MG), blood urea nitrogen (BUN) and ereatinine (Cr). Significant positive relationships were found both between urine IL 6 and TNF, and between IL 6 and IL 8 ( r =0.5621, P <0.05; r =0.3845, P <0 01). Conclusion TNF, IL 6 and IL 8 were highly activated during the course of the disease. IL 6 was associated with the immunopathological lesions caused by the hyperfunction of humoral immune response. IL 6, IL 8 and TNF were involved in the renal immune impairment and their determinations might be used in predicting the prognosis and outcome of patients with HFRS to certain extent.