甲型H1N1流感病毒感染者早期血清中细胞因子分泌水平及其意义分析  

Analysis of cytokine secretion level and its significance at early stage of patients infected with pandemic influenza A( H1N1)

作　　者：王冰[1] 张春青[1] 王萍[1] 郑丽[2] 车雷[1] 

机构地区：[1]沈阳市疾病预防控制中心,辽宁沈阳110031 [2]中国医科大学,辽宁沈阳110013

出　　处：《中国卫生检验杂志》2015年第15期2513-2515,共3页Chinese Journal of Health Laboratory Technology

基　　金："艾滋病和病毒性肝炎等重大传染病防治"科技重大专项(2012ZX10002-001)

摘　　要：目的了解甲型H1N1流感病毒感染患者早期血清中细胞因子分泌水平,并探讨其与流行特征、临床诊疗间的关系。方法采集2009年沈阳地区罹患呼吸道感染疾病患者感染早期标本并分组。应用real-time PCR方法确认阳性患者,ELISA方法检测血清中细胞因子水平,采用t检验进行分析处理。结果甲型H1N1流感重症组与同期病毒性重症肺炎对照组(非甲型H1N1流感)相比,IFN-γ和IL-10分泌水平明显下降,差异有统计学意义(P<0.05),虽然TNF-α分泌水平略有增高,IL-6分泌水平略有降低,但二者差异均无统计学意义(P>0.05),而2组的IL-10、IL-6、TNF-α分泌水平均明显高于正常对照组,差异有统计学意义(P<0.05)。结论甲型H1N1流感重症患者不能产生高水平IFN-γ和IL-10,导致病毒清除障碍,抗炎机制建立较慢。TNF-α和IL-6仅作为此类重症肺炎患者的早期免疫反应,对疾病鉴别无诊断意义。Objective To understand the level of cytokine secretion in early serum of patients with influenza a H1N1 influenza virus infection and to investigate the relationship between them and the epidemic characteristics,clinical diagnosis and treatment. Methods The early infection of respiratory tract infections samples in Shenyang area in 2009 were collected and divided into different groups. Real- time PCR was applied to confirm pandemic H1N1 positive cases. The cytokine levels in serum were measured by ELISA,and statistical analysis was performed by t test. Results Compared with those in virus pneumonias group,the levels of IFN- γ and IL- 10 secretion level in pandemic influenza A（ H1N1） infected group decreased,and the diffenences had statistical significance（P〈0. 05）. Although the level of TNF- α secretion increased slightly,the level of IL- 6 secretion decreased slightly,but the difference was not statistically significant between the two groups（P〈0. 05）. The secretion levels of IL- 10,IL- 6,TNF- α in disease group obviously haigher than the control group and the differences had statistical significance（P〈0. 05）. Conclusion The patients infected with pandemic H1N1 failed to produce enough IFN- γ and IL- 10,which might result in the disorder of viral clearance or the delay of viral clearance. TNF- α and IL- 6 are only used as early immune responses in the patients with severe pneumonia,and have no diagnostic significance in the differential diagnosis of the disease.

关 键 词：流感病毒A型 细胞因子 固有免疫 

分 类 号：R511.7[医药卫生—内科学]