克罗恩病患儿血清细胞因子水平的研究

Serum cytokine level in children with Crohn's disease

目的通过研究克罗恩病(CD)患儿血清细胞因子水平,探讨其在儿童CD发病与发展中的作用。方法采用流式微球分析技术,检测2013年1月至2015年12月在温州医科大学附属第二医院住院的32例CD患儿和30名正常对照儿童的血清白介素(IL)-2、IL-4、IL-6、IL-10、肿瘤坏死因子(TNF)-α、干扰素(IFN)-γ、IL-17A水平,并进行统计分析。结果 CD患儿血清中的IL-2、IL-4、IL-6、TNF-α、IL-17A水平均显著高于正常对照组(t值分别为2.822、2.643、5.713、2.962、3.183,均P<0.05);而血清中的IL-10、IFN-γ水平则显著低于正常对照组(t值分别为2.554、2.634,均P<0.05)。此外,儿童CD活动指数(PCDAI)评分为中重度的患儿血清TNF-α、IL-2和IL-17A水平显著高于评分为轻度的患儿(t值分别为2.233、2.332、2.531,均P<0.05);而血清IFN-γ、IL-4、IL-6及IL-10水平的PCDAI评分则中重度活动与轻度活动CD患儿差异均无统计学意义(均P>0.05)。结论与正常儿童相比,CD患儿存在明显细胞因子水平变化,而且疾病活动度不同其细胞因子水平亦有差异,提示细胞因子水平紊乱在儿童CD发病及病情的发展中有重要作用。

Objective To explore the serum cytokine level in children with Crohn＇s disease（ CD） and to investigate its relationship with incidence and development of CD in children. Methods Serum interleukin（ IL）-2,IL-4,IL-6,IL-10,tumor necrosis factor（ TNF）-α,interferon（ IFN）-γ and IL-17 A levels in 32 children with CD hospitalized in Second Affiliated Hospital of Wenzhou Medical University from January 2013 to December 2015 and in 30 healthy children were detected using flow cytometry and test results were analyzed statistically. Results Serum levels of IL-2,IL-4,IL-6,TNF-α and IL-17 A in children with CD were significantly higher than those in healthy controls（ t value was 2. 822,2. 643,5. 713,2. 962 and 3. 183,respectively,all P〈0. 05）,while serum levels of IL-10 and IFN-γ in CD children were much lower than those in healthy controls（ t value was 2. 554 and 2. 634,respectively,both P〈0. 05）. In addition,serum levels of TNF-α,IL-2 and IL-17 A in moderate and severe cases identified by pediatric Crohn＇s disease activity index（ PCDAI） were significantly higher than in mild cases（ t value was 2. 233,2. 332 and 2. 531,respectively,all P〈0. 05）. But serum levels of IFN-γ,IL-4,IL-6 and IL-10 in moderate and severe cases identified by PCDAI had no significant difference compared to those in mild cases（ all P〈0. 05）. Conclusion Compared to healthy children,serum cytokine levels in children with CD change significantly,and cytokine levels are different in cases at different degree of disease activity,indicating that cytokine level disorder may play an important role in incidence and development of pediatric CD.