难治性肺炎患儿细胞因子水平变化及意义

Changing of Serum Cytokines in Children with Refractory Pneumonia and Its Clinical Significance

目的探讨难治性肺炎患儿细胞因子水平变化及临床意义。方法整群选取129例难治性肺炎支原体肺炎(RMPP)患儿为研究对象,并将其归入研究组(A组);将同期入院体检的50例同龄健康志愿者纳入对照组(B组)。所有受试患儿均予以双抗夹心酶联免疫吸附法(ELISA)检测,记录其血清白细胞介素-2(I L-2)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)和肿瘤坏死因子-α(T N F-α)、γ-干扰素(IFN-γ)等指标检测情况。A组患儿予以静注甲泼尼龙方案,对比其治疗前后检测结果差异。结果①两组受试者在IL-2及TNF-α两项炎性细胞因子水平对比上差异无统计学意义(P>0.05);A组IL-4、IL-6、IL-8、IL-10及IFN-γ水平均明显高于B组,差异有统计学意义(P<0.05);②治疗后,A组患儿除IL-2及TNF-α水平较治疗前无明显改变外,其他炎性细胞因子水平均较治疗前明显降低,差异有统计学意义(P<0.05)。结论临床可将IL-4、IL-6、IL-8、IL-10和IFN-γ等炎性细胞因子作为早期诊断RMPP的重要依据推广使用。

Objective To investigate the changing of serum cytokines in children with refractory pneumonia and its clinical significance. Methods 129 patients with refractory mycoplasma pneumoniae pneumonia （RMPP） were selected as research object and aasigned to study group （group A）;50 healthy volunteers who took physical examination during the same period were enrolled in control group （group B）. Of all the children, the serum level of interleukin-2 （I L-2）, interleukin-4 （IL-4）, interleukin-6 （IL-6）, interleukin -8 （IL-8）, interleukin -10 （IL-10） and tumor necrosis factor -α （T N F-α）、γ- interferon IFN-γ） and other indicators were recorded and detected by double-antibody sandwich ELISA. Patients in the Group A were treated intravenous injection of methylprednisolone and detection results before and after the treatment were compared. Results ①The difference of the levels of two inflammatory cytokine , IL-2 and TNF-alpha ,of the two groups was not statistically significant （P〉0.05）;The levels of IL-4, IL-6, IL-8, IL-10 and IFN-γ the of the group A were significantly higher than those of the group B, and the differences were statistically significant（P〈0.05）; after the treatment, except the level of IL-2 and TNF-α, other inflammatory cytokine levels of the groups A were significantly lower than that before treatment , and the differences were statistically significant （ P〈0 . 05 ） . Conclusion Inflammatory cytokines such as IL-4, IL-6, IL-8, IL-10 and IFN–γ can be used as important basis in early diagnosis of RMPP.