免疫性血小板减少症患儿血清IL-2、4、6、10和TNF-α、IFN-γ的变化及其临床意义

Changes of IL2,4,6,10 and TNF-α,IFN-γ and Its Clinical Significance in Children with Immune Thrombocytopenia

目的通过检测免疫性血小板减少症(ITP)患儿治疗前、后外周血白细胞介素(IL)、肿瘤坏死因子-a(TNF-a)与γ-干扰素(IFN-γ)水平的变化,探讨它们在儿童ITP发生、发展及糖皮质激素治疗中的作用。方法选择2010年10月-2012年6月在宁夏医科大学总医院儿科住院治疗的ITP患儿50例,同期门诊体检的健康儿童50例作为正常对照组,于清晨空腹抽取外周血,采用酶联免疫吸附试验(ELISA)测定ITP患儿治疗前、后及50名正常对照者血清IL-2、IL-4、IL-6、IL-10、TNF-α、IFN-γ水平,所有ITP患儿行骨髓细胞学检查巨核细胞数量。结果 50例ITP患儿治疗前血清IL-2、IL-6、TNF-α及IFN-γ水平明显高于治疗后及正常对照组(P<0.05、P<0.01);血清IL-4、IL-10水平明显低于治疗后及正常对照组(P<0.01)。ITP患儿治疗后除IL-6外,其余各项指标均恢复至正常对照组的水平(P>0.05)。结论 ITP患儿存在多种细胞因子的异常,经有效治疗后,多数细胞因子可恢复至正常。定期检测ITP患儿外周血中IL、TNF-α和IFN-γ水平的变化,可能有助于判断其病情变化、治疗效果及预后。

Objective To explore the opment of ITP, as well as the response roles of II2,4,6,10 and TNF - α ,IFN - γ in the occurrence and devel- to glucocorticoid treatment. Methods 50 children with ITP hospitalized in Pediatrics Department of General Hospital of Ningxia Medical University from October 2010 to June 2012 were enrolled while 50 healthy children were selected as control group. Peripheral blood samples were collected in the morning in all children. The level of IL2,4,6,10 and TNF - α ,IFN - γ in the plasma was measured by enzyme -linked immunosorbent assay （ELISA）. Results Compared with the indicators measured after treat- ment in patients with ITP and normal control group, serum IL - 2, IL - 6, TNF - α ,IFN - γ levels were sig- nificantly higher （P 〈 0. 05 or P 〈 0. 01 ）, while serum IL - 4, IL - 10 levels were significantly lower （ P 〈 0.01 ） before treatment. Except IL -6, all the indicators in ITP patients after treatment were restored to the same level as normal control group （P 〉 0.05 ）. Conclusion ITP is an autoimmune disease and there exists a variety of cytokines abnormality. Most of the cytokines return to normal level following effective treatment. De- tecting the changes of serum IL, TNF - α ,IFN - γ levels regularly in ITP patients is helpful in judging the their condition, the treatment effect and the prognosis.