血清干扰素γ、白细胞介素18在早期梅毒的表达及临床意义

Expression of serum interferon gamma or interleukin 18in early syphilis and its clinical significance

目的探究血清干扰素γ(IFN-γ)、白细胞介素18(IL-18)在早期梅毒表达及临床意义,为指导临床诊断和治疗提供依据。方法回顾性分析2008年3月-2010年11月104例早期梅毒住院患者临床资料,按照其临床分型分为Ⅰ期梅毒组33例、Ⅱ期梅毒组36例、早期潜伏梅毒组35例,并选取同期门诊健康体检者35名为正常组,使用双抗体夹心ELISA法对血清IFN-γ及IL-18进行检测,对比4组人群的血清IFN-γ及IL-18指标。结果3组患者IFN-γ与IL-18浓度均显著高于正常组,其中以Ⅰ期梅毒组最高,分别为(231.6±19.7)ng/L及(86.4±7.1)ng/L,Ⅱ期梅毒组分别为(199.0±16.5)ng/L及(65.6±6.8)ng/L,两期对比差异有统计学意义(P<0.05);快速血浆反应素试验(RPR)与IFN-γ及IL-18均无明显相关性(P>0.05),IFN-γ与IL-18呈明显正相关(r=0.795,P<0.05)。结论 IFN-γ与IL-18在早期梅毒患者血清中呈高表达,且二者呈正相关,随着患者梅毒分期进展而降低,其免疫应答由Th1优势型转为Th2优势型,免疫水平不断降低,预后较差;检测早期梅毒患者血清IFN-γ与IL-18可作为确认其临床分型、指导用药、判断预后的有效手段。

OBJECTIVE To study the expression of serum interferon gamma（IFN-γ）or interleukin 18（IL-18）in the early syphilis and observe its clinical significance so as to provide the basis for clinical diagnosis and treatment.METHODS The clinical data of 104cases of early syphilis patients who were hospitalized from Mar 2008to Nov 2010were retrospectively analyzed,according to the clinical typing,the subjects were divided into phaseⅠsyphilis group with the 33cases,the phaseⅡsyphilis group with 36cases,and the early latent syphilis group with 35 cases,while 35people who underwent medical examination were set as the control group,then the serum IFN-γ and IL-18were detected through double antibody sandwich ELISA,and the serum IFN-γand IL-18were compared between the four groups.RESULTS The concentrations of the IFN-γand IL-18of the three groups were significantly higher than those of the control group;the concentrations of the IFN-γand IL-18of the patients with phase Ⅰsyphilis were（231.6±19.7）ng/L and（86.4±7.1）ng/L,respectively,which were respectively（199±16.5） ng/L and（65.6±6.8）ng/L in the patients with phaseⅡ syphilis,the difference between the two phases was significant（P0.05）;there was no significant correlation between RPR and IFN-γand IL-18（P0.05）,IFN-γ was positively correlated with IL-18（r=0.795,P0.05）.CONCLUSIONThere are the high expression of IFNγand IL-18in serum of the patients with early syphilis,the two are positively correlated and decrease with the progression of staging of syphilis,indicating the transition of the immune response from Th1type to the Th2 type,with the prognosis poor.The detection of serum IFN-γand IL-18in the early syphilis patients is an effectively way to confirm the clinical typing,guide the drug therapy,and determine the prognosis.