炎性细胞因子检测在噬血细胞综合征诊断中的应用  

The application of detection of inflammatory cytokines in hemophagocytic syndrome

作　　者：王宇[1] 卫青[2] 李硕[2] 张嘉[2] 王旖旎[2] 王昭[2] 

机构地区：[1]首都医科大学附属北京同仁医院,北京100730 [2]首都医科大学附属北京友谊医院血液科

出　　处：《临床内科杂志》2014年第9期637-639,共3页Journal of Clinical Internal Medicine

基　　金：国家自然科学基金资助项目（81270653）;首都医学发展科研基金资助项目（2009-1032）;北京市科技计划首都临床特色应用研究（D101100050010005）;北京友谊医院科研启动基金资助项目（YYQD-KT2011-6）

摘　　要：目的 探讨炎性细胞因子检测在噬血细胞综合征（HPS）诊断中的作用.方法 选取北京友谊医院2011年6月～ 2013年1月收治的HPS患者90例;健康志愿者27例;淋巴瘤、自身免疫病患者各20例;全身炎症反应综合征（SIRS）患者16例作为不同病因相关HPS患者对照.采用酶联免疫吸附法（ELISA）检测所有HPS患者确诊时血清干扰素（IFN）-γ、白细胞介素（IL）-12、IL-10、IL-1β、IL-2、核因子（NF）-κb p65、sCD25水平,并对健康志愿者、患者对照组及临床治疗有效患者治疗2周时的上述细胞因子水平比较各组间差异.结果 淋巴瘤相关性HPS（LAHS）血清sCD25、IFN-γ、IL-2、IL-10、NF-κb p65水平均高于初发淋巴瘤患者（P均＜0.01）;自身免疫性疾病相关性HPS （AAHS）血清sCD25、IL-10、NF-κb p65、IFN-γ.明显高于自身免疫病患者（P均＜0.01）;感染相关HPS （IAHS）血清sCD25、IFN-γ、IL-10、NF-κb p65均高于SIRS患者（P均＜0.05）.在临床治疗有效的患者中,sCD25、IFN-γ、IL-10、NF-κb p65水平较确诊时明显降低（P均＜0.01）.结论 检测sCD25、IFN-γ、IL-10、NF-κb p65对鉴别HPS与其相似疾病具有重要意义,监测上述细胞因子可能有助于判断疾病活动性.Objective To explore the role of detection of inflammatory cytokines in HPS diagnosis. Methods Between June 2011 and January 2013,90 HPS patients in Beijing Friend Hospital were collected. And 27 healthy volunteers were recruited, as well as 20 patients with autoimmune disease and lymphoma respectively, and 16 patients with systemic inflammatory reaction syndrome. The levels of serum IFN-γ,IL-12,IL-10,IL-113, IL-2, NF-κb p65, sCD25 of all HPS patients and volunteers and each control group were tested by ELISA, and those results were compared in each group. Results Serum levels of sCD25 and IL-2, IL-IO, NF-κb p65, IFN-γ in LAHS were higher than those in the new diagnosed lymphoma patients （ P 〈 0.01 ）. Serum levels of sCD25, IL-10, NF-κb p65, IFN-γ were significantly higher than those in patients with autoimmune disease（ P 〈 0. 01 ） , serum levels of sCD25 and IL-10, NF-κb p65, IFN-γ were higher than those in patients with SIRS（P 〈 0.05）. Serum levels of sCD25, IFN-γ, IL-10, NF-κb p65 were decreased in patients with clinical response（P 〈 0.01 ）. Conclusion It maybe helpful to detect the serum levels of sCD25, IL-10, NF-κb p65, and IFN-γ in order to differentiate HPS from other similar diseases. Monitoring the those cytokines may contribute to decide the disease activity.

关 键 词：噬血细胞综合征 炎症细胞因子 鉴别诊断 

分 类 号：R446.61[医药卫生—诊断学]