摘要
目的探讨血清IL-18在重症肠道病毒71型(EV71)感染患儿中的变化及意义。方法选择重症EV71感染患儿48例为研究对象,根据病情轻重分为3组:中枢神经系统病变组(CNSD组)20例,中枢神经系统病变伴自主神经功能失调组(ANSD组)23例,中枢神经系统病变伴肺水肿组(PE组)5例,健康同龄儿童15例为健康对照组(NC组)。ANSD组和PE组行机械通气辅助呼吸。重症EV71感染患儿在入院时检测血清IL-18水平并进行比较。同时动态监测ANSD组和PE组在上呼吸机第1天、第2天、第4天血清IL-18水平。血清IL-18测定采用双抗体夹心ELISA法。结果 1.PE组血清IL-18明显高于ANSD组、CNSD组及NC组,差异均有统计学意义,其他各组间比较均无统计学差异。2.PE组和ANSD组血清IL-18随病情减轻而下降。PE组血清IL-18水平上机第1天显著高于第2天、第4天(Pa<0.005),上机第2天显著高于第4天(P<0.05);ANSD组血清IL-18水平上机第1天显著高于第2天、第4天(Pa<0.005),上机第2天显著高于第4天(P<0.05)。结论 IL-18可能参与EV71感染的发病过程,尤其与肺水肿密切相关,动态观察患儿血清IL-18水平变化可能有助于判断病情和预后。
Objective To explore the changes of serum interleukin-18（IL-18） in severe cases with enterovirus 71（EV71） infection and its significance.Methods Forty-eight severe cases with EV71 infection were selected.The patients were divided into 3 groups accor-ding to the extent of severity of EV71 infection：central nervous system disease（CNSD） group（n=20）,autonomic nervous system dysregulation（ANSD）group（n=23）,and pulmonary edema（PE） group（n=5）,and 15 healthy children were selected as healthy control group（NC group）.The patients in ANSD group and PE group accepted mechanical ventilation support.The levels of serum IL-18 of patients in 3 groups were measured soon after admission to the hospital.The levels of serum IL-18 of patients in ANSD group and PE group were measured respectively on the 1st day,the 2nd day,and the 4th day after the mechanical ventilation.The level of serum IL-18 were measured by enzyme-linked inmunosorbent assay method.Results 1.The levels of serum IL-18 in PE group were extremely higher than those in ANSD group,CNSD group and NC group,and the differences were significant.There was no significant difference among other groups.2.The serum levels of IL-18 of patients of PE group and ANSD group gradually decreased with the alleviation of disease.In PE group,the serum levels of IL-18 on the 1st day were higher than those on the 2nd day and the 4th day after the mechanical ventilation（Pa〈0.005）,and the serum levels of IL-18 on the 2nd day were higher than those on the 4th day after the mechanical ventilation（P〈0.05）.In ANSD group,the serum levels of IL-18 on the 1st day were higher than those on the 2nd day and the 4th day after the mechanical ventilation（Pa〈0.005）.And the serum levels of IL-18 on the 2nd day were higher than those on the 4th day after the mechanical ventilation（P〈0.05）.Conclusions IL-18 can play an important role in the pathogenesis of EV71 infection and is closely associated with PE.Dynamic assay of serum IL-18 levels in patients with EV71 infection may facilitate the evaluation of severity and prognosis of the disease.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2010年第18期1401-1403,共3页
Journal of Applied Clinical Pediatrics
