老年肺部感染患者IL-6、IL-8和TNF-α测定及其意义

Clinical significance of the serum levels of IL-6,IL-8 and TNF-α in elderly patients with acute pulmonary infection

目的 探讨老年慢性阻塞性疾病 (COPD)患者合并肺部感染时外周血细胞因子白细胞介素 6(IL 6)、白细胞介素 8(IL 8)、肿瘤坏死因子 (TNF α)和可溶性白细胞介素 2受体 (sIL 2R)的变化 ,及其与感染的相互关系。 方法 采用ABC HRP方法测IL 6,IL 8。双抗体夹心ABC ELISA法检测TNF α ,双抗体夹心ELISA检测sIL 2R水平。分别检测了 2 5名正常人 (A组 )、5 5例老年COPD合并肺部感染急性期 (B组 )、2 1例老年COPD合并肺部感染好转期 (C组 )患者外周血IL 6、IL 8、TNF α和sIL 2R的水平。 结果 B组和C组的血sIL 2R水平均较A组明显升高 (P <0 0 1)。而B组和C组的血sIL 2R水平比较 ,则无明显差异 (P >0 0 5 )。B组的血IL 6水平明显高于A组(P <0 0 5 )。而C组IL 6水平虽高与A组 ,并且低于B组该值 ,无统计学上意义 (P >0 0 5 )。B组和C组的血IL 8水平均低于A组 ,但无统计学意义。 3组之间TNF α水平比较 ,以B组升高最显著 ,C组次之 ,分别与对照组比较均有显著差异 ,P分别 <0 0 1和 0 0 5。B组与C组比较 ,也有显著差异 (P <0 0 5 )。 结论 细胞因子IL 6、TNF α和sIL 2R水平与老年COPD合并肺部感染的严重程度有关 ,并且 3者之间呈正相关。故对其监测 ,将有利于疾病的分期和活动情况的判断 。

Objective To study the immunopathogenic changes of IL 6,IL 8,TNF α,sIL 2R and their clinical significance in elderly patients with acute pulmonary infection. Methods We evaluated the serum levels of these cytokines by sandwich ELISA method from 55 patients with pulmonary infection(group B),21 with stable pulmonary infection(group C)and 25 healthy control subjects(group A). Results Serum levels of sIL 2R were significantly higher in group B and group C than those in group A ( P <0 01).There was no difference in sIL 2R between group B and group C( P >0 05).Levels of IL 6 were higher in group B than those in group A and group B ( P <0 05).Levels of TNF α were significantly increased in both group B and group C,compared with group A ( P <0 01, P <0 05 respectively). Conclusions These results showed that the serum levels of IL 6,IL 8,TNF α and sIL 2R are correlated with severity of the disease and may be helpful as a marker to evaluate the therapeutical effects and recovery of disease.