肺炎合并脓毒症儿童血清细胞因子变化及意义

Changes of serum cytokines and their significance in children with pneumonia and sepsis

目的检测肺炎合并脓毒症患儿外周血中白介素(IL)-2、IL-6、IL-8及IL-10等炎性因子水平,观察免疫功能紊乱在儿童脓毒症中的作用。方法选取2013年1月至2014年12月西安交通大学第二附属医院收治的52例肺炎合并脓毒症患儿为肺炎合并脓毒症组,同期收治的肺炎患儿50例为肺炎组,对102例患儿进行了详细的病史询问,体格检查,外周血测查;检测C反应蛋白(CRP)、IL-2、IL-6、IL-8及IL-10等细胞因子水平,并对检测结果进行分析。结果肺炎合并脓毒症组患儿外周血白细胞(WBC)计数、中性粒细胞比值以及血涂片杆状粒细胞比例较肺炎组患儿均显著升高,差异均有统计学意义(t值分别为6.89、4.78、2.42,均P<0.05)。肺炎合并脓毒症组患儿外周血CRP较肺炎组患儿显著升高,差异有统计学意义(t=8.76,P<0.01)。肺炎合并脓毒症组患儿外周血IL-2、IL-6、IL-8较肺炎组患儿显著升高(t值分别为9.34、7.45、5.05,均P<0.01);而肺炎合并脓毒症组患儿外周血IL-10与肺炎组患儿相比轻度升高,但差异无统计学意义(P>0.05)。结论 IL-2、IL-6、IL-8及IL-10等因子在脓毒症的发生发展中具有重要作用。

Objective To detect IL-2,IL-6,IL-8 and IL-10 levels in peripheral blood in children with pneumonia and sepsis so as to observe the role of immune dysfunction in child sepsis. Methods Fifty-two children with pneumonia and sepsis visiting the Second Affiliated Hospital of Xi＇an Jiaotong University from January 2013 to December 2014 were selected aspneumonia and sepsis group,and 50 children with pneumonia visiting the same period were chosen as pneumonia group. The 102 children were demanded a detailed history,physical examination and peripheral blood examination. The levels of C-reactive protein（ CRP）,IL-2,IL-6,IL-8 and IL-10 in blood were detected and the results were analyzed. Results The peripheral white blood cell（ WBC） count,neutrophil cell ratio and the ratio of rod-likeg ranulocytes in blood smear were significantly higher in children with pneumonia and sepsis than those in the pneumonia group,and the differences had statistical significance（ t value was 6. 89,4. 78,and 2. 42,respectively,all P〈0. 05）. The CRP of peripheral blood in the pneumonia and sepsis group was significantly higher than that in the pneumonia group with statistical significance（ t = 8. 76,P〈0. 01）. IL-2,IL-6 and IL-8 of peripheral blood were significantly higher in children with pneumonia and sepsis than those in children in the pneumonia group（ t value was 9. 34,7. 45 and 5. 05,respectively,all P〈0. 01）,but IL-10 in children with pneumonia and sepsis was slightly higher than that in the pneumonia group with no statistical significance（ P〉0. 05）. Conclusion IL-2,IL-6,IL-8 and IL-10 play an important role in the occurrence and development of sepsis.