囊型包虫病致过敏性休克患者IFN-γ和IL-4的表达及其意义

Expression and significance of IFN-γ and IL-4 in patients with anaphylactic shock induced by ruptured cystic echinoccocus

目的观察囊型包虫病致过敏性休克患者血清中干扰素-γ(IFN-γ)和白细胞介素-4(IL-4)的动态变化,了解其在休克发生发展过程中的作用。方法 11例包虫病致过敏性休克患者列为休克组,22例未发生过敏性休克包虫病患者列为对照组。ELISA法测定血清中IFN-γ和IL-4水平,并进行病例对照研究和Pearson相关分析。结果休克组IFN-γ水平与术前基础值相比,囊液外溢时达最低值(179.166±42.534)ng?L,之后上升,囊液外溢第7 d达到峰值(239.097±60.728)ng?L;IL-4术前基础值为(455.243±81.684)ng?L,囊液外溢第7 d达到峰值(521.061±77.805)ng?L。对照组IFN-γ和IL-4分别在囊液外溢1 h和囊液外溢时降至最低,分别为(99.423±11.922)ng?L和(329.273±21.756 ng)?L,其余各时点与术前基础值相比均有不同程度的降低。两组比较,休克组IFN-γ和IL-4所有观察时点均高于对照组,休克组IFN-γ在囊液外溢1 h和第1 d及第7 d均高于对照组(P<0.05),IL-4含量均高于对照组(P>0.05)。各时点间IFN-γ与IL-4呈显著正相关(P<0.05)。结论在包虫病所致过敏性休克过程中,IFN-γ和IL-4具有协同作用,导致Th1/Th2平衡失调。这可能是包虫病所致过敏性休克不同于其他过敏性休克的原因。

Objective To observe the dynamic change of IFN-γ and IL-4 in serum and its clinical significance in patients with Cystic Echinoccocus（CE）.Methods 11 patients with anaphylactic shock induced by CE were enrolled the shock group,other 22 patients without anaphylactic shock were enrolled the control group.The level of IFN-γ and IL-4 in serum wered detected by ELISA,and the date were analyzed by Case-control study and Pearson correlation.Results Compared with the basic level before operation,IFN-γ in the shock group reached minimum value at the time of cyst rupture at（179.166±42.534） ng∕L,then rised,and reached a peak 7 days after cyst rupture at（239.097±60.728）ng∕L.IL-4 reached（455.243±81.684） ng∕L before operation and reached a peak 7 days after cyst rupture at（521.061±77.805） ng∕L.IFN-γ and IL-4 in the control group reached minimum value 1 hour after cyst rupture and at the time of cyst rupture respectively at（99.423±11.922） ng∕L and（329.273±21.756） ng∕L respectively.Compared with the basic level before operation,they decreased,to some extent,at other times.Compared with the control group,the levels of IFN-γ and IL-4 increased at all observed times： IFN-γ in the shock group was significantly higher 1 hour,1day and 7 days after cyst rupture than that in the control group（P0.05）;IL-4 was significantly higher at all the times than that in the control group（P0.05）.IFN-γ and IL-4 had a significant positive correlation among all the times.Conclusion During the course of anaphylactic shock in patients induced by CE,IFN-γ and IL-4 plays a synergistic role to lead to the Th1/Th2 imbalance in patients with anaphylactic shock induced by CE,and this may imply the difference of anaphylactic shock induced by CE.