老年肾综合征出血热患者外周血单个核细胞产生细胞因子能力研究

Cytokine presentation of mononuclear cell with in the peripheral blood(PBMC) of the elderly hemorrhagic fever patients complicated with renal syndrome

目的 探讨细胞因子在老年肾综合征出血热 (HFRS)发病中的作用。方法 检测 42例老年 HFRS患者血清中 IL- 6、IL- 2和 TNF含量。 PHA刺激体外培养的 HFRS患者外周血单个核细胞 (PBMC) ,观察产生 IL - 6、IL- 2和 TNF能力。将 HFRS患者血清加入正常的 PBMC进行体外培养 ,检测 IL - 6、IL- 2和 TNF的分泌量。结果 老年 HFRS患者血清 IL - 6、IL - 2和 TNF含量较对照组明显增高(P<0 .0 1 ) ,IL- 6、IL- 2的高峰值在少尿期 ,TNF的高峰值在低血压期。PHA刺激 HFRS患者 PBMC产生 IL- 6、IL- 2和 TNF在发热期已达高水平 ,低血压期、少尿期持续在高水平 ,多尿期开始下降。加入 HFRS患者血清后 ,正常人 PBMC在 PHA刺激下产生的 IL - 6、IL - 2和 TNF减少 ,特别是在少尿期与正常组比较减少更明显 (P<0 .0 5,P<0 .0 5,P<0 .0 1 )。结论 HFRS患者在发病初期 PBMC既处于活化状态 ,在发病过程中产生大量细胞因子 ,参与肾脏的免疫损伤。 HFRS患者血清中存在对 PBMC产生细胞因子有抑制作用的物质 ,细胞因子在免疫性损伤中的作用取决于 PBMC的分泌量与抑制物质的抑制的双重作用。

To explore the role of cytokines in the pathogenesis of the elderly hemorrhagic fever patients complicated with renal syndrome(HFRS).Methods the serum IL 6、IL 2 and TNF were detected from 42 elderly ptients with HFRS.The PBMC from the HFRS patients cultured in vitro were stimulated by PHA,Then the concentrations of IL 6、IL 2 and TNF were determined.Results Serum IL 6、IL 2、TNF production in HFRS patients were significantly higher than the control( P <0 01),IL 6、IL 2 increased to peak at oliguria statge,and TNF to peak at hypotension stage.IL 6、IL 2 and TNF produced by PBMC stimulated with PHA in vitro were increased significantly at fever stage,continued in high levels at hypotension stage and oliguria stage.Conclusion PBMC from elderly HFRS patients were highly activated during the fever stage and cytokines produced during the course of the disease,taking part in the immune injury of the kindey.