幼年型类风湿性关节炎病儿Th1/Th2应答状态研究  

A STUDY ON IMMUNE RESPONSES OF Th1/Th2 IN CHILDREN WITH JUVENILE RHEUMATOID ARTHRITIS

作　　者：张秋业[1] 张惠君[1] 董增义[1] 

机构地区：[1]青岛大学医学院附属医院儿内科,山东青岛266003

出　　处：《青岛大学医学院学报》2004年第2期134-136,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：①目的　研究幼年型类风湿性关节炎 (JRA)病儿Th1 /Th2免疫应答状态。②方法　ELISA法测定35例JRA和 1 8例健康儿童γ 干扰素 (IFN γ)和白细胞介素 4 (IL 4 )诱生水平。根据临床亚型、不同病程、血清免疫球蛋白增高和抗核抗体存在与否进行比较。③结果　JRA病儿IFN γ诱生水平与正常对照组比较无明显差异(t=1 .5 8,P >0 .0 5 ) ,而IL 4水平显著高于对照组 (t=4 .36 ,P <0 .0 1 ) ,IFN γ/IL 4比值明显低于对照组 (t=2 .2 2 ,P <0 .0 5 ) ;各临床亚型间IFN γ和IL 4水平及IFN γ/IL 4比值比较无显著性差异 (F =0 .2 6～ 1 .5 3,P >0 .0 5 ) ;病程≥ 1年者IL 4水平明显高于 <1年者 (t=2 .6 4 ,P <0 .0 5 ) ,而IFN γ水平和IFN γ/IL 4比值比较无显著性差异 (t=0 .4 1、0 .86 ,P >0 .0 5 ) ;免疫球蛋白增高 (1种或多种 )组与正常组的IFN γ水平无明显差异 (t=0 .6 0 ,P>0 .0 5 ) ,而IL 4水平显著增高 (t=2 .89,P <0 .0 1 ) ,IFN γ/IL 4比值明显降低 (t=2 .5 4 ,P <0 .0 5 ) ;血清抗核抗体阳性组与阴性组比较 ,其IFN γ和IL 4水平及IFN γ/IL 4比值皆无显著性差异 (t=0 .5 2～ 1 .5 1 ,P >0 .0 5 )。④结论幼年型类风湿性关节炎存在Th2细胞免疫应答过强现象 ,各临床亚型间无明显差异。Objective To study the immune responses of Th1 and Th2 subsets of T cells in children with juvenile rheumatoid arthritis(JRA). Methods The levels of IL-4 and IFN-γ were measured in 35 JRA and 18 healthy children with ELISA. The clinical subtypes, various duration of JRA, increased sera immunoglobulin level and anti-nuclear antibody(ANA) were compared between the two groups. Results The IFN-γ levels were not significantly different between JRA children and normal controls ( t=1.58, P >0.05). The levels of IL-4 were significantly higher than those of normal controls ( t=4.36, P <0.01). The IFN-γ/ IL-4 ratio were significantly lower than those of normal controls ( t=2.22, P <0.05). The levels of IFN-γ, IL-4 and IFN-γ/ IL-4 ratio were not significantly different among three clinical subtypes of JRA ( F=0.26-1.53, P >0.05). The IL-4 levels in patients with JRA for more than one year were significantly higher than those for less than one year ( t=2.64, P <0.05), but no significant difference existed in the levels of IFN-γ and IFN-γ/ IL-4 ratio ( t=0.41,0.86, P >0.05). The levels of IFN-γ were not significantly different between the patients with increased Ig and the normal controls ( t=0.60,P >0.05), but the levels of IL-4 increased significantly ( t=2.89, P <0.01) and the ratio of IFN-γ/ IL-4 decreased significantly ( t=2.54, P <0.05). The levels of IFN-γ and IL-4 and IFN-γ/ IL-4 ratio were not significantly different between the patients with positive serum ANA and those with negative ANA ( t=0.52-1.51, P >0.05). Conclusion The immune response of Th2 cells increase in JRA patients. No significant difference exists among the three clinical subtypes. The increased immune response activity of Th2 cells may play an important role in the pathogenesis of JRA.

关 键 词：关节炎 幼年型类风湿 儿童 干扰素Ⅱ型 白细胞介素4 

分 类 号：R725.9[医药卫生—儿科]