肾综合征出血热患者血清MCP-1、IFN-γ、IL-10、E-选择素和ICAM-1的变化  

The role of serum MCP-1,IFN-γ,IL-10,E-selectin and ICAM-1 in the pathogenesis of hemorrhagic fever with renal syndrome

作　　者：王锁荣[1] 孙志坚[2] 卢建平[1] 张东军[1] 马志俊[1] 章莉莉[2] 

机构地区：[1]丹阳市人民医院,212300 [2]南京医科大学第一附属医院

出　　处：《江苏医药》2007年第12期1192-1195,共4页Jiangsu Medical Journal

摘　　要：目的研究单核细胞趋化蛋白1(MCP-1)、γ干扰素(IFN-γ)、E-选择素、细胞间黏附分子1(ICAM-1)和白细胞介素10(IL-10)在肾综合征出血热(HFRS)发病机制中的作用。方法29例HFRS患者按病情分为轻症组15例和重症组14例,另取20例健康者作对照。每例均按病期采血,用ELISA方法检测血清MCP-1、IFN-γ、E-选择素和ICAM-1含量,用放射免疫法(RIA)检测IL-10,并同时作肝、肾功能和血常规检查。结果从发热期至多尿期,血清MCP-1、IFN-γ、E-选择素、ICAM-1均显著高于对照组水平,至恢复期则逐渐趋向正常,其变化曲线与ALT、BUN的变化趋势相似,而与血小板计数(Plt)的变化趋势相反;血清IL-10在病程前四期也见增高,但其增幅远不及IFN-γ;轻、重两组急性期IFN-γ/IL-10比值均显著升高,两组的峰值分别为0.45±0.75和0.23±0.25,均明显高于对照组(0.12±0.16)(P<0.01)。结论HFRS急性期血清MCP-1、IFN-γ、E-选择素、ICAM-1以及IFN-γ/IL-10比值均显著升高,且与肝、肾损害呈相关性,提示趋化因子与黏附分子之过度表达,加上1型与2型辅助性T细胞(TH1/TH2)之失平衡,在HFRS发病机制中起着重要的作用;合理的对症治疗和适量使用免疫调节剂可望改善本病的预后。Objective To evaluate the role of serum levels of monocyte chemoattractant protein- 1 （MCP-1）, interferon-γ（ IFN-γ）, interleukin-10 （ IL-10 ）, E-selectin （E-sel） and intercellular adhesion molecule-1 （ICAM-1） in the pathogenesis of hemorrhagic fever with renal syndrome（HFRS）. Methods Twenty-nine HFRS patients were assigned to moderate group（ 15 cases） and severe group（ 14 cases） according to their illness condition, and 20 healthy volunteers were selected as the controls. Serum levels of MCP-1, IFN-γ, E-sel and ICAM-1 were detected by enzyme-linked immunosorbent assay （ELISA）, and IL-10 by radioimmunoassay, platelets were counted, alanine aminotransferase （ALT） and blood urea nitrogen（BUN） were tested by automatic biochemical analyzer, respectively. Results Compared with the controls, the serum concentrations of MCP-1, IFN-γ, E-sel and ICAM-1 were all increased significantly during the first three stages of HFRS, thereafter they tended to return to normal range. The curves of them were similar to those of ALT and BUN, but were contrary to platelet counts. Although serum levels of IL-10 were also elevated, the peak values of IFN-γ/IL-10 ratio in moderate（0. 45±0.75） and severe HFRS patients（0.23±0. 25） were statistically higher than those in the controls（0. 12±0. 16）. Conclusions Serum levels of MCP-1,IFN-γ,E-sel,ICAM-1 and IFN-γ/IL-10 ratio were significantly increased during the course of HFRS suggesting that these chemokines and cytokines might be the important factors leading to systemic inflammatory response and imbalance in TH1/TH2 cells, which were involved in the pathogenesis of HFRS. The combination of symptomatic therapy with immunomodulators would improve the prognosis of this disease.

关 键 词：肾综合征出血热 单核细胞趋化蛋白1 Γ干扰素 E-选择素 细胞间黏附分子1 白细胞介素10 

分 类 号：R512[医药卫生—内科学]