肾综合征出血热患者血清IL-12、IFN-γ和IL-4水平及临床意义

Dynamic Changes and Clinical Significance of Serum IL-12,IFNγ,IL-4 in Patients with Hemorrhagic Fever with Renal Syndrome

探讨肾综合征出血热(HFRS)血清Th1/Th2代表性细胞因子白细胞介素-12(IL-12)、γ干扰素(IFN-γ)和白细胞介素-4(IL-4)在发病中的作用。44例患者(轻症组20;重症组24)按病期采集血液,用ELISA法和放射免疫法检测IL-12、IFN-γ和IL-4,并同步检测血像和BUN。结果发现,从发热期至多尿期血清IL-12含量均见升高,轻症组的峰值为1.42±1.10μg/L,重症组的峰值为2.11±2.13μg/L,皆显著高于对照组(0.56±0.10μg/L)水平。IFN-γ的变化情况与IL-12相似,轻、重二组之峰值分别为15.95±18.05μg/L和5.94±8.24μg/L,与对照组(0.27±0.15μg/L)相比,有显著性差异。IL-4在病程中变化不明显;IL-12之变化曲线与血尿素氮(BUN)的变化趋势相一致,而与血小板(BPC)的变化趋势相反。肾综合征出血热病程中IL-12、IFN-γ大量释放,而IL-4相对不足、导致Th1/Th2细胞平衡偏移,产生多器官免疫病理损伤。对症积极治疗可改善本病预后。

To investigate the changes and pathogenic significance of serum interleukin-12p70（IL-12）,interferon γ（IFN γ） and IL-4 in patients with hemorrhagic fever with renal syndrome（HFRS）,44 patients were divided into moderate group（20 cases） and severe group（24 cases） according to the severity of illness.The serum levels of IL-12 and IFN γ were detected by enzyme-linked immunosorbent assay,serum IL-4 was tested by radioimmunoassay,blood urea nitrogen（BUN） and platelet were measured by automatic biochemical analyzer and blood analyze.The results showed that the serum levels of IL-12 significantly increased during the first stages of HFRS compared with control group（0.56±0.10μg/L）,with a peak value（1.42±1.10μg/L） in moderate group and a peak value（2.11±2.13μg/L） in severe group.The changes of serum IFN γ were same as that of IL-12,and its peak values（15.95±18.05μg/L in moderate group and 5.93±8.24μg/L in severe group） were much higher than that of control group（0.27±0.15μg/L,P0 01）.The serum IL-4 was in normal range with no changes.The changes curve of IL-12 was similar to that of BUN but was contrary to blood platelet count.The elevated serum levels of IL-12 and IFN γ with the imbalance of Th1∕Th2 might be the main cause of systemic inflammatory response and involved in the pathogenesis of HFRS.The combination of reasonably symptomatic therapy with immunoregulator should be considered to accelerate recovery of immune function and homeostasis and to improve the prognosis of disease.