感染相关性噬血细胞综合征患者干扰素γ、IP-10和CXCR3的表达及临床意义

Expressions of IFNγ,IP-10 and CXCR3 in infection-associated hemophagocytic syndrome and their clinical significance

目的 探讨细胞因子干扰素γ（IFNγ）、干扰素诱导蛋白10（IP-10）及受体CXCR3在感染相关性噬血细胞综合征（infection-associated hemophagocytic syndrome,IAHPS）患者中的表达及临床意义.方法 采用酶联免疫吸附试验（ELISA）检测43例IAHPS患者血清IFNγ和IP-10的表达,以流式细胞术检测外周血CD_4~＋和CD_8~＋T淋巴细胞表面CXCR3的表达,并以无HPS感染组（35例）和健康体检者（20名）作为对照.采用SPSS 13.0软件分析数据,组间比较采用独立样本t检验.结果 IAHPS组血清IFNγ和IP-10水平分别为（608±135）pmol/L和（939±141）pmol/L,明显高于无HPS感染组[（154±45）pmol/L、（385±119）pmol/L,t值分别为4.97和4.02,P值均〈0.05]和健康对照组[（56±18）pmol/L、（248±98）pmol/L,t值分别为5.27和4.77,P值均〈0.05].IAHPS组的CD4＋和CD8＋T淋巴细胞表面CXCR3的表达分别为（35±11）%和（23±8）%,明显高于无HPS感染组[（24±7）%、（16±7）%,t值分别为3.12和3.62,P值均〈0.05]和健康对照组[（20±6）%、（12±5）%,t值分别为4.46和4.93,P值均〈0.05].结论 IAHPS患者外周血IFNγ和IP-10表达明显升高,CD_4~＋和CD_8~＋T淋巴细胞上的受体CXCR3表达也增强,这些趋化因子的异常表达可能与HPS的发病机制相关.

Objective To investigate the expressions of interferon γ（IFNγ）, interferon inducible protein-10（IP-10）. chemokine receptor CXCR3 and their significance in infection-associated hemophagocytic syndrome（IAHPS）. Methods Forty-three patients with IAHPS, 35 infection patients without HPS and 25 healthy controls were included in the study. The serum IFNγ and IP-10 levels were measured by enzyme linked immunosorbent assay（ELISA）. The expression of CXCR3 on cell surface of CD_4~＋ and CD_8~＋ T cells in peripheral blood was determined by flow cytometry. SPSS 13.0 was used for data processing, and independent-sample t test was performed to compare the differences among the groups. Results The serum IFNγ and IP-10 levels in patients with IAHPS were（ 608±135） pmol/L and（939±141） pmol/L respectively, which were significantly higher than those in without HPS group[（154±45） pmol/L and （385±119） pmol/L, t=4.97 and 4.02, P〈0.05] and healthy controls[（56±18） pmol/L and （248±98） pmol/L, t=5.27 and 4.77, P〈0.05]. The expressions of CXCR3 on CD_4~＋ and CD_8~＋ T cells in IAHPS group were （35±11）% and （23±8）% respectively, which were significantly higher than those in without HPS group[（24±7）% and （16±7）%, t=3.12 and 3.62, P〈0.05] and healthy controls[（20±6）% and （12±5）%, t=4.46 and 4.93, P〈0.05]. Conclusion The expressions of IFNγ, IP-10 and CXCR3 are increased significantly in patients with IAHPS, which may be related to the disease pathogenesis.