噬血细胞综合征患者血清TNF-α和IFN-γ水平及临床意义

Serum Levels of Tumor Necrosis Factor α and Interferon γ in Patients with Hemophagocytic Syndrome and Its Clinical Significance

本研究旨在探讨噬血细胞综合征(HPS)患者血清肿瘤坏死因子(TNF)-α和干扰素(IFN)-γ水平及临床意义。收集2008年10月至2010年10月经首都医科大学附属北京友谊医院确诊的30例HPS患者临床资料,同时以20名健康人作为对照。采用酶联免疫吸附(ELISA)方法分别检测患者及对照者血清TNF-α和IFN-γ水平,分析TNF-α和IFN-γ水平与HPS原发病的关系,并于当日检测血红蛋白、铁蛋白、甘油三酯、NK细胞活性、sCD25水平,并对HPS患者血清TNF-α和IFN-γ水平与上述指标进行相关性分析。结果表明,HPS组和健康对照组血清TNF-α和IFN-γ水平差异具有统计学意义(p<0.05和p<0.01);肿瘤相关性HPS组和风湿免疫相关HPS组血清TNF-α浓度差异具有统计学意义(p<0.05);TNF-α与血红蛋白水平呈负相关关系(p=0.025,r=-0.558),与其余指标均无相关性。结论:高水平的TNF-α和IFN-γ参与了HPS的发生发展,TNF-α可能是导致HPS血红蛋白降低的主要因素。

In order to explore the serum levels and clinical significance of tumor necrosis factor alpha（TNF-α）and interferon gamma（IFN-γ）in patients with hemophagocytic syndrome（HPS）.The clinical data of HPS patients in Capital Medical University Beijing Friendship Hospital from October 2008 to October 2010 were collected.The serum concentration of TNF-α and IFN-γ in HPS patients and 20 healthy controls was measured with enzyme-linked immunosorbent assay（ELISA）.The correlations between the levels of TNF-α and primary disease were analyzed,the levels of hemoglobin,ferritin,triglyceride,NK cell activity and sCD25 were detected on the same day,the correlations between the concentrations of TNF-α and IFN-γ and these laboratory indicators were analyzed.The results indicated that the serum levels of TNF-α and IFN-γ in 30 cases of HPS was higher than that in control group（p〈0.05,p〈0.01）; the difference of TNF-α concentration was statistically significant in rheumatism-related and tumor-related HPS groups（p=0.04）,the level of TNF-α in HPS patients showed negative correlation with hemoglobin.It is concluded that the high levels of TNF-α and IFN-γ in HPS patients may play certain roles in the pathogenesis and progress of HPS.These data indicated that the high level of TNF-α may be the main factor for anemia in patients with HPS.