肾综合征出血热患者T淋巴细胞亚群及IL-6和IL-10的变化  

The changes of T-lymphocyter subsets and IL-6,IL-10 levels in patients with hemorrhagic fever with renal syndrome(HFRS)

作　　者：王经伟[1] 张东辉[1] 

机构地区：[1]临沂市人民医院感染科,山东临沂276003

出　　处：《实用医药杂志》2006年第12期1432-1434,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的研究肾综合征出血热(HFRS)患者外周血T细胞亚群及血浆IL-6、IL-10水平的变化,并研究其相关性,以探讨其在HFRS发病机制中的作用。方法应用流式细胞仪检测41例HFRS患者外周血及10例正常人外周血的T淋巴细胞CD3及亚群CD4、CD8细胞的数量及CD4/CD8比值;同时应用双抗体夹心ELISA法检测血清IL-6、IL-10水平。结果HFRS患者病程中存在CD3、CD4、CD8细胞数量的不同程度升高,CD3、CD8细胞于发热期明显升高(P<0.05或P<0.01),均于低血压期达峰值(P<0.01);CD4细胞升高幅度较小,于少尿期达峰值(P<0.01);CD4/CD8比值下降或倒置,于低血压期比值降至最低(P<0.01);血清IL-6、IL-10水平在病程中均明显升高(P<0.01),于少尿期达峰值。在HFRS不同病型中,随临床病型的加重,CD3、CD8细胞明显升高,在危重型升高达峰值(P<0.01),而CD4细胞升高幅度相对较小,在重型升高达峰值(P<0.01);CD4/CD8比值明显降低;血清IL-6、IL-10水平明显升高;CD4/CD8比值的下降与血清IL-6、IL-10水平的升高相一致,呈明显的负相关(P<0.01),相关系数分别为r=-0.9278和r=-0.8787。结论细胞免疫功能紊乱与细胞因子分泌失常介导的体液免疫功能亢进在HFRS发病机制中起重要作用。Objective To study the changes of T-lymphocyte subsets in peripheral blood and serum IL-6,IL-10 levels in patients with HFRS and to find out the relationship among them, so as to explore the role of them in the pathogenesis of HFRS. Methods T- lymphocyte CD3, subsets CD4 and CD8 cells in peripheral blood of the 41 patients with HFRS were detected by flow cytometry; the IL-6,IL-10 levels in serum of 41 patients were detected by double antibody sandwich ELISA method. Results In the course of HFRS,CD3,CD4,CD8 cells increased at different level, CD3,CD8 cells increased significantly in fever phase（P〈0.05 or P〈0.01）,peaked in hypotensive phase（P〈0.01）; the increase degree of CD4 cells was lower, CD4 cells peaked in oliguric phase （P〈0.01）; CD4/CD8 ratio decreased or deversed,it was the lowest in hypotensive phase; serum IL-6,IL-10 levels increased significantly,peaked in oIiguric phase. In different types of HFRS patients, along with the severity of disease, CD3,CD8 cells increased significantly, peaked in gravis type （P〈0.01）, but the increase degree of CD4 cells was lower relatively,CD4 cells peaked in severe type（P〈0.01）; CD4/CD8 ratio decreased significantly; serum IL-6,IL-10 levels increased significantly; the decrease of CD4/CD8 ratio was consistent with the increase of serum IL-6,IL-10 levels, an obvious negative correlation was observed between them, the coefficients（r） were-0.9278 and -0.8787 （P〈0.01）. Conclusion The immune disturbance of cellular immune function and enhanced humoral immune function interposed by interleukins plays an important role in the pathogenesis of HFRS.

关 键 词：肾综合征出血热 T淋巴细胞亚群 白细胞介素6 白细胞介素10 流式细胞术 

分 类 号：R512.8[医药卫生—内科学]