免疫相关性血细胞减少患者血清细胞因子变化与骨髓免疫的相关性

Analysis on the relativity of serum cytokines with patient's bone marrow immunity in immune related hematocytopenia

目的检测89例免疫相关性血细胞减少(IRH/IRP)患者外周血细胞因子的变化状况,观察骨髓细胞活化状态,探讨IRH/IRP的免疫相关机制。方法 ELISA方法检测IRH/IRP患者外周血清IL-2、IL-4、IL-6和IFN-γ的含量,分析患者组和正常对照组间细胞因子含量的差异,并对患者组Th1类细胞因子与Th2类细胞因子变化的相关性和升高率以及骨髓细胞免疫活化状况与细胞因子变化的相关性进行分析。结果 89例患者血清IL-4、IL-6和IFN-γ呈现不同程度明显升高(P<0.01),其中IFN-γ显著高于正常对照组,分别为(38.75±3.67)pg/ml和(8.69±1.68)pg/ml。患者Th1活化相关细胞因子的升高率与Th2活化相关细胞因子的升高率相比具有统计学差异。结论 IFN-γ的变化与IRH/IRP者细胞免疫活化密切相关,IL-4和IL-6可能参与与IRH/IRP体液免疫的活化,感染等可加重多重免疫活化,细胞因子含量和骨髓细胞免疫状况的监测有助于IRH/IRP的诊断并有利于评价患者的免疫机能状态。

Objective To investigate the immunity related pathogenic mechanism of IRH/IRP through detecting bone marrow immunity state associated with serum cytokines. Methods Cell immunity activation of IRH/IRP patients were analyzed. The peripheral blood of 89 patients were collected with asepsis method. Serum concentration of cytokine IL - 2, IL - 4, IL - 6 and IFN - γ were detected by ELISA reagent kit. The disparity of concentration between the patients group and the control group were analyzed by t test statistically ,the correlation analysis of patient group between Thl cytokines and Th2 cytokines were also performed. The correlation between marrow cell immunity state and cytokine concentration was analyzed. Results Serum concentration of cytokine IL - 4, IL - 6 and IFN - γ in patient group were increased differently （ P 〈 0. 01 ） respectively. The average serum level of cytokine IFN - γ was of statistical distinction（ 38.75 ± 3.67 VS 8.69 ± 1.68 pg/ml）. The increase rates between Thl cytokines and Th2 cytokines of patients were also significantly. Conclusion Cytokine IFN - 3＇ participates in pathogenesis of cell immunity in IRI-I/IRP patients ; IL - 4 and IL - 6 may be related with activation of humoral immunity. Infection could aggravate the immunity activation and lead to immunologic injury. Analysis of serum cytokine and cell immunity in bone marrow is useful for diagnosis and evaluation of the immunological function.