摘要
目的探讨肾综合征出血热(HFRS)血清IL-12、IFN-γ、IL-4、血浆D-二聚体(D-D)和血管血友病因子(vWF)在发病中的作用。方法 25例患者(轻症组14;重症组11)按病期采集血液,用ELISA法和放射免疫法检测白细胞介素-12p70(IL-12p70)、γ干扰素(IFN-γ)和白细胞介素-4(IL-4)、D-二聚体(D-D)和血管血友病因子(vWF),并同步检测血象和BUN。结果从发热期至恢复期IL-12p70、IFN-γ、D-二聚体(D-D)、血管血友病因子(vWF)含量与对照组相比均见升高(P<0 01～<0 05),而IL-4变化不明显。BUN与IL-12、D-D、vWF呈一致变化,而BPC的变化相反。结论肾综合征出血热病程中IL-12、IFN-γ大量释放,而IL-4相对不足、导致Th1/Th2细胞平衡偏移及血浆D-D、vWF含量增高,产生多器官免疫病理损伤,对症积极治疗可改善本病预后。
Objective To investigate the changes and pathogenic significance of serum interleukin-12p70（lL-12）, interferonT（IFNT） .interleukin-4（IL-4） .plasma D-dimer（D-D） and von Willebrand factor（vWF） in the course of hem- orrhagic fever with renal syndrome （ HFRS ）. Methods 25 cases were divided into either moderate group（14 cases） or severe group（ll cases） according to the severity of illness. Serum levels of IL-12,IFNTand vWF were detected by en- zyme-linked immunosorbent assay（EL1SA）,IL-4 by radioimmunoassay （RIA）,blood urea nitrogen （BUN） and platelet by automatic biochemical analyzer and and hematology analyzer. D-D were detected by Thrombolyxer Compact-x analy- zer. Results The serum levels of IL-12 were significantly increased during the HFRS as compared with control group （0.56±0.10 ng/mL） ,with a peak value （1.29±1.03 ng/mL） in moderate group and a peak value （2.32±2.38 ng/ mid in severe group. The changes of serum 1FN7 like that of IL-12 ,and its peak values（8.04± 13.05 ng/mL in moder- ate group and 9.54±8.24 ng/mL in severe group respectively） were much higher than control group （0.27±0.15 ng/ mL ,P〈0 01）. The concentrations of IL-4 were in normal range. The plasma levels of vWF,D-D were significantly in- creased during the HFRS as compared with control group（171.79±29.47 ng/ml and 0.68±0.56 ng/ml respectively,P 〈0 01） ,with a peak value （351.00±46.58 ng/mL and 2.03±0.50 ng/ml respectively） in moderate group and a peak value （361.90±34.66 ng/ml and 3.42±2.33 ng/mL respectively） in severe group. The curve of IL-12 ,D-D ,vWF was similar to that of BUN,but was contrary to blood platelet count. Conclusion The elevated levels of IL-12 and IFN7 with the imbalance of Thl / Th2 might be the main cause of systemic inflammatory response and involved in the pathogenesis of HFRS and increment of the D-D,VWF in the plasma. We suggest that the combination of reasonably symptomatic therapy with immunoregulator should be considered to accelerate recovery of immune function and homeo- stasis ,and to improve the prognosis of this disease.
出处
《中国实验诊断学》
2013年第10期1830-1833,共4页
Chinese Journal of Laboratory Diagnosis
关键词
肾综合征出血热
Γ干扰素
白细胞介素
D-二聚体
血管血友病因子
hemorrhagic fever with renal syndrome, interleukin-12, interferon7, interleukin-4 , D-dimer , Willebrandfactor
