过敏性紫癜患儿血清白细胞介素-17水平变化的意义

Changes of Serum Level of Interleukin-17 in Children with Henoch-Schonlein Purpura and Its Clinical Significance

目的探讨不同临床类型、不同时期的过敏性紫癜(HSP)患儿血清IL-17水平及其临床意义。方法选择2009年9-12月住院治疗的HSP患儿41例作为研究对象,采用双抗体夹心ELISA法检测HSP患儿急性期及缓解期血清IL-17水平。同期选取健康儿童20例作为健康对照组。应用SPSS11.0软件进行统计学分析。结果 HSP患儿急性期血清IL-17水平较健康对照组明显下降(t=-4.156,P<0.01);缓解期与健康对照组比较差异无统计学意义;急性期与缓解期比较差异有统计学意义(t=-3.993,P<0.01);不同临床类型HSP急性期血清IL-17水平比较差异无统计学意义;但重症胃肠型HSP患儿急性期血清IL-17水平异常增高;急性期血清IL-17水平降低与血清IgG、CRP、尿微量清蛋白、尿转铁蛋白均呈正相关(IgG:r=0.564,P<0.01;CRP:r=0.545,P<0.01;尿微量清蛋白:r=0.681,P<0.01;尿转铁蛋白:r=0.471,P<0.01)。结论 HSP患儿存在T淋巴细胞免疫功能紊乱,血清IL-17水平变化反映了HSP的病情状况,同时可能为HSP肾炎的早期诊断提供线索。

Objective To explore the changes of serum level of interleukin-17（IL-17） in different stages of Henoch-Schonlein purpura（HSP） in children and its clinical significance.Methods Forty-one children with HSP were selected from Sep.2009 to Dec.2009.The serum concentration of IL-17 was measured by enzyme linked immunosorbent assay（ELISA） in acute stage and remission stage of HSP,and 20 healthy children were studied as healthy control group.The data were analyzed by SPSS 11.0 software.Results Serum level of IL-17 in acute HSP was significantly lower than that in healthy control group（t=-4.156,P〈0.01）and also was significantly lower than that in remission stage（t=-3.993,P〈0.01）.Serum level of IL-17 in remission stage had no significant difference compared with that in healthy control group.According to different clinical types,the serum level of IL-17 had no difference in statistics,except for children with severe gastrointestinal hemorrhage,the level of IL-17 in acute stage was significantly higher than that in healthy control group.Serum level of IL-17 in acute had a positive correlation with immunoglobulin G（IgG）（r=0.564,P〈0.01）,C-reactive protein（CRP）（r=0.545,P〈0.01）,urine microalbumin（r=0.681,P〈0.01） and urine transferrin（r=0.471,P〈0.01）.Conclusions T cells maybe involved in the pathophysiology of HSP.The changes of serum level of IL-17 reflect pathogenetic condition,so it may provide clinical clues for the inchoate diagnosis of HSP nephritis.