甲/乙流感病毒感染患儿Th1/Th2相关细胞因子水平变化及临床应用价值

目的探讨流感病毒感染患儿血清中相关细胞因子水平变化特点及流式细胞微球技术检测相关细胞因子的临床应用价值.方法2017年10月至2018年4月应用胶体金标记免疫层析技术进行流感抗原检测为阳性的患儿124例为流感组,同时选取体检健康幼儿86例为对照组,应用BD FACS Calibur流式细胞仪微球技术检测Th1和Th2相关细胞因子水平.比较两组血常规、CRP等指标的变化.结果与正常对照组比较,流感组CRP明显升高,WBC、嗜酸性粒细胞(Eos)、淋巴细胞(Lym)、血小板(PLT)则明显下降,差异均有统计学意义(P<0.05).甲型/乙型流感组患儿血清IL-2、TNF-α、IL-6、IL-10水平明显高于对照组(H分别为10.43、6.78、114.26、67.43,P<0.05);而IL-4则明显低于对照组(H=8.34,P<0.05),IFN-r在三组差异无统计学意义(H=0.746,P=0.653).与乙流组比较,甲流组中IL-6明显高于前者(Z=-6.75,P<0.05).结论通过对相应细胞因子检测,特别是IL-6和IL-10,可被认为对流感病情进展具有指示作用.现症流感患儿其Th1/Th2平衡失调与漂移可能是流感发生发展的重要免疫学机制.流式细胞微球技术具有快速准确检测血清微量细胞因子的作用,对于疾病的评估及预测进程与归转,具有一定的应用价值.

Objective To detect the change trend about the main cytokines which secreted by Th1 and Th2 about the children with influenza virus A/B infection.And to discuss the clinical application value about cytokines which detected by cytometric bead array.Methods From October 2017 to April 2018,the 124 patients of children whom were consulted in fever clinics in our hospital were diagnosed as influenza virus A/B infection which were detected as positive using Immunochromatogragphic assay.The 86 healthy children which physical examination in our hospital were selected as control group.The BD FACS Calibur flow cytometry analyzer was used to analyze the cytokines of Th1/Th2.Meanwhile the items such as WBC,Neu,Lym,Eos,PLT and CRP in patients with influenza infection were detected and analyzed.Results Compared with the normal group,the CRP in the influenza A/B group were higher than the normal group,and WBC,Eos,Lym,PLT were significantly decrease(P<0.05).The cytokines such as IL-2,TNF-α,IL-6,IL-10 of patients group showed significantly higher than the normal group(H value:10.43,6.78,114.26,67.43,P<0.05),and the level of IL-4 showed significantly decrease(H=8.34,P<0.05).The level of IFN-γshowed no statistical significantly among the three group(H=0.746,P=0.653).The IL-6 level in FLU type A group were significantly higher than the FLU type B group(Z=-6.75,P<0.05).Conclusions It is found from the experiments,especially the IL-6 and IL-10,can be used as the important indicators for disease progression assessment.The Th1/Th2 imbalance and shift maybe the important pathogenesis which caused the development of influenza.The cytometric bead array has the ability to detect the serum trace of cytokines fast and precisely,it has important application value to evaluate the severity and predict the prognosis for influenza.