糖皮质激素对重症肌无力患者外周血T淋巴细胞Fas表达的影响

目的 探讨糖皮质激素治疗重症肌无力(MG)与Fas介导的细胞凋亡的关系.方法 选择17例MG患者,其中6例接受糖皮质激素治疗(糖皮质激素治疗组),11例未接受糖皮质激素治疗(无糖皮质激素治疗组);另选择同期健康自愿献血者13例作为健康对照组,采用流式细胞技术检测三组外周血T淋巴细胞表面CD4、CDs及Fas的表达.结果 糖皮质激素治疗组外周血T淋巴细胞表面CD4-CD8+表达高于健康对照组[(36.75±11.56)%比(26.31±9.00)%],CD4-CD8-表达低于健康对照组[(30.56±9.72)%比(42.96±11.54)%],差异有统计学意义(P=0.027、0.018);糖皮质激素治疗组外周血T淋巴细胞表面CD4-CD8+表达高于无糖皮质激素治疗组[(36.75±11.56)%比(25.24±7.63)%],差异有统计学意义(P=0.019).糖皮质激素治疗组外周血T淋巴细胞表面Fas+、CD8+Fas+表达高于健康对照组[(46.10±7.13)%比(31.22±13.00)%,(62.86±12.29)%比(45.59±11.50)%],差异有统计学意义(P=0.006、0.003).糖皮质激素治疗组CD8+Fas+表达高于无糖皮质激素治疗组[(62.86±12.29)%比(50.84±8.31)%],差异有统计学意义(P=0.034).结论 糖皮质激素治疗对MG患者外周血T淋巴细胞亚群分布具有影响.Fas介导的细胞凋亡可能是糖皮质激素治疗MG的机制之一.

Abstract：

Objective To investigate the relation between Fas-mediated apoptosis and glucocorticoid treatment in myasthenia gravis (MG). Methods In 17 patients with MG, 6 patients received glucocorticoid treatment (glucocorticoid treatment group),and 11 patients were treated without glucocorticoid (nonglucocorticoid treatment group). Meanwhile, 13 healthy cases were selected as healthy control group. CD4,CD8 and Fas expressions in peripheral blood T lymphocyte were detected by flow cytometry in three groups and analyzed. Results The percentage of CD4-CD8+ cells in peripheral blood T lymphocyte in glucocorticoid treatment group was significantly higher than that in healthy control group[(36.75 ± 11.56)% vs. (26.31 ±9.00)%, P = 0.027], while the percentage of CD4-CD8- cells was significantly lower [(30.56 ± 9.72)% vs.(42.96 ± 11.54)%, P =0.018]. The percentage of CD4-CD8+ cells in peripheral blood T lymphocyte in glucocorticoid treatment group was significantly higher than that in non-glucocorticoid treatment group [(36.75 ± 11.56)% vs. (25.24 ±7.63)% ,P =0.019]. The percentages of Fas+ and CD8 +Fas+ cells in peripheral blood T lymphocyte in glucocorticoid treatment group were significantly higher than those in healthy control group[(46.10 ± 7.13)% vs. (31.22 ± 13.00)%, P=0.006; (62.86 ± 12.29)% vs. (45.59 ±11.50)%, P = 0.003]. The percentage of CD8+ Fas+ cells in peripheral blood T lymphocyte in glucocorticoid treatment group was significantly higher than that in non-glucocorticoid treatment group [(62.86 ± 12.29)%vs (50.84 ± 8.31 )%, P = 0.034]. Conclusions Glucocorticoid treatment may have influence on peripheral blood T lymphocyte subsets in patients with MG. Fas-mediated apoptosis may be involved in the mechanism of glucocorticoid treatment in MG.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

热性惊厥患儿血清褪黑素水平和细胞免疫功能的变化及其临床意义

Objective To investigate the changes of melatonin and cellular immunological function in children with febrile seizures and its clinical significance. Methods 50 children, including 23 cases with complex febrile seizure (CFS) and 27 cases with simple febrile seizure (SFS) , and 25 cases with upper respiratory infections children selected as control group were enrolled in this study. Serum melato- nin was measured by enzyme-linked immunosorbent assay (ELISA) and cellular immunological function was measured by flow eytomcter. Results The levels of serum melatonin in the 3 groups of CFS, SFS, control were(14. 91±2. 61) ng/L, (20. 72±2. 54) ng/L, (23.93± 2. Ol) ng/L, respectively. The melatonin levels in CFS children were significantly decreased than that in control group and SFS children (P <0. O1). CD3 + ,CD4 +, the ratio of CD4 + /CD8 + and CD8 + in CFS group were significantly decreased than that in control group and SFS group (P <0.01). The ratio of CD4 +/CD8 + in SFS group was significantly decreased than that in control group (P <0.05), but CD3 + ,CD4 + and CD8 + had no statistics significance among these groups(P >0. 05). The serum rnelatonin level were positive related withdecreaseddegreeofCD3+,CD4+ andtberatioofCD4+ /CDS+ (r≥0. 472, P <0.05). Conclusion The disorder cfcellular immunological function was possible related with the loss of serum melatonin, and the loss of serum melatonin maybe one of the reasons for febrile seizures relapse and brain injured.     

特发性血小板减少性紫癜患者外周血淋巴细胞亚群和血小板特异性抗体检测的临床意义

目的 检测特发性血小板减少性紫癜(ITP)患者外周血淋巴细胞亚群、血小板膜糖蛋白(GPⅡb/Ⅲa、GPⅠb/Ⅸ)特异性抗体变化,探讨相关因素在ITP发病机制中的作用.方法 用流式细胞术检测72例ITP患者(ITP组)和50例健康体检者(对照组)外周血淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+、CD19+变化.应用改良血小板抗原单克隆抗体固相化检测技术测定GPⅡb/Ⅲa、GPⅠb/Ⅸ特异性抗体变化.结果 ITP组与对照组比较,GPⅡb/Ⅲa、GP Ⅰ b/Ⅸ特异性抗体吸光度值升高(P＜0.05),CD3+、CD4+、CD4+/CD8+显著下降(P＜0.01),CD8+、CD19+显著增高(P＜0.01).结论 淋巴细胞亚群及血小板特异性抗体可较好地反映ITP的病理机制,在ITP的发病机制中起非常重要的作用.     

烹调烟雾对人体免疫功能的影响

目的　通过对烹调烟雾职业暴露人群外周血免疫指标的测定了解烹调烟雾对机体免疫功能的影响。方法　对被试者 70人 ,其中暴露组 41人 ,对照组 2 9人。分别通过流式细胞仪直接荧光法、四甲基偶氮唑盐 (MTT)比色法、放射免疫分析法、生物素 -亲和素双抗体夹心酶联免疫吸附 (ABC- EL ISA)技术分析人外周血 T、B淋巴细胞及亚群、自然杀伤细胞 (NK细胞 )活性、白细胞介素 - 2 (IL- 2 )、γ-干扰素 (IFN- γ)水平。结果　经成组 t检验 ,暴露组 CD3+细胞百分率、NK细胞杀伤率明显低于对照组 (P<0 .0 1) ,工龄 7年以上被调查者中暴露组 CD4+ CD8- T细胞百分率、CD4+ / CD8+细胞比值明显低于对照组 (P<0 .0 5 ) ;而 CD8+ CD4- T、CD19+细胞百分率、IL- 2、IFN- γ水平两组间差异无统计学意义 (P>0 .0 5 )。结论　长期接触烹调烟雾对机体细胞免疫功能有一定抑制作用     

血必净注射液对重症脓毒症患者机体炎性反应和细胞免疫功能的影响

目的 评价血必净注射液对重症脓毒症患者机体炎性反应和细胞免疫功能的影响.方法 选择2008年9月至2009年8月ICU收治的62例确诊重症脓毒症患者,按随机数字表法分为治疗组30例和对照组32例,两组均给予脓毒症集束化治疗,治疗组加用血必净注射液100ml静脉滴注,2次/d,连续使用7d,观察两组患者治疗前后血清肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-10、C反应蛋白(CRP)以及外周血T淋巴细胞亚群CD4+、CD8+、CD4+CD8+和CD14+单核细胞人类白细胞抗原(HLA)-DR表达的变化.结果 两组患者治疗前血清TNF-α、IL-6、IL-10和CRP水平以及外周血CD4+、CD8+、CD4+/CD8+和CD14+单核细胞HLA-DR表达比较差异无统计学意义(P＞0.05).与对照组比较,治疗组治疗后血清TNF-α、IL-6、IL-10、CRP水平显著降低[(64.4±13.5) ng/L比(96.1 ±22.1) ng/L,(153.8 ±23.8) ng/L比(180.1 ±21.7) ng/L,(73.8±13.8) ng/L比(101.1±11.7)ng/L,(53.7±18.8) mg/L比(91.3±32.8) mg/L,P＜ 0.05],而外周血CD4+、CD8+、CD4+/CD8+升高(0.311±0.021比0.424±0.035,0.201±0.017比0.238±0.038,1.78±0.21比1.56±0.18,P＜ 0.05 ),CD14+单核细胞HIA-DR表达上调[(38.4±11.5)％比(18.1±12.1)％,P＜0.05].结论 血必净注射液可降低重症脓毒症患者机体炎性反应,纠正细胞免疫功能紊乱,有助于改善患者病情.     

肺结核患者血清骨桥蛋白检测及临床意义

目的 了解骨桥蛋白(OPN)在肺结核中的临床意义.方法 对80例抗结核治疗前肺结核患者[病例组,其中单纯肺结核60例(单纯肺结核组),肺结核合并结核性胸膜炎20例(肺结核合并胸膜炎组)]血清OPN水平进行检测,并与30例健康体检者(健康对照组)、20例有效抗结核治疗随访6个月后的患者(随访组)进行对比,同时依据临床常用结核检测指标研究OPN的临床意义.结果 病例组血清OPN水平[(843.49±569.23) ng/L]较健康对照组[(352.50±185.02) ng/L]明显升高,差异有统计学意义(P＜0.05).随访组治疗后血清OPN水平[(494.11±352.40) ng/L]较治疗前[(1106.60±628.39) ng/L]明显降低,差异有统计学意义(P＜0.05).随访组治疗后血清OPN水平与健康对照组比较差异无统计学意义(P＞0.05).肺结核合并胸膜炎组血清OPN水平[(1179.80±606.33) ng/L]高于单纯肺结核组[(727.53±511.66) ng/L],差异有统计学意义(P＜0.05);而且两组OPN水平均高于健康对照组,差异有统计学意义(P＜0.05).单纯肺结核组患者有空洞者血清OPN水平[ (836.51±549.80) ng/L]高于无空洞者[(535.52±375.95)ng/L],差异有统计学意义(P＜0.05);病变范围累及＜3叶与≥3叶患者、痰结核菌阳性与阴性患者、结明试验阳性与阴性患者、红细胞沉降率升高与正常患者、PPD强阳性与非强阳性患者血清OPN水平比较差异均无统计学意义(P＞0.05).结论 OPN与肺结核活动性密切相关,血清OPN水平可以作为判断肺结核活动、病情转归的临床指标,血清OPN水平与肺结核病情严重程度有一定相关性.     

连续硬膜外自控镇痛对剖宫产术后产妇恢复及血清泌乳素的影响

目的　探讨连续硬膜外自控镇痛对剖官产术后产妇恢复及血清泌乳素的影响.方法将86例行剖宫产术产妇按随机数字表法分为两组,观察组43例采用连续硬膜外自控镇痛,对照组43例采用哌替啶肌肉注射,比较两组的镇痛效果及血清泌乳素水平变化.结果观察组镇痛优良率[79.1％　(34/43)]明显高于对照组[20.9％　(9/43)](P＜0.05).观察组术后泌乳素水平[(542.17±46.75)μg/L]较术前[(351.13±20.92)μg/L]明显升高(P＜0.05),且明显高于对照组术后[(362.12±24.33)μ　g/L](P＜　0.05).观察组的初乳时间[(15.21±3.26)h]明显早于对照组[(21.16±4.78)　h](P＜　0.05).结论连续硬膜外自控镇痛对剖官产术后产妇进行镇痛,可以达到良好的镇痛效果,有利于产妇的恢复,促进血清泌乳素的分泌,值得临床推广应用.     

子宫内膜异位症患者外周血干扰素γ、白细胞介素4和白细胞介素6的变化及其临床意义

目的 探讨子宫内膜异位症(EM)患者外周血干扰素γ(IFN-γ)、白细胞介素4(IL-4)和白细胞介素6(IL-6)的变化及其临床意义.方法 用双抗体夹心酶联免疫吸附(ELISA)法检测25例EM患者(EM组)及20例盆腔结构正常患者(对照组)外周血IFN-y、IL-4、IL-6水平.结果 EM组患者外周血IFN-γ[(109.64±26.79)ng/L]明显低于对照组[(155.17±30.36)ng/L](P＜0.05),IL-4[(33.52±8.69)ng/L]、IL-6[(44.12±3.57)ng/L]明显高于对照组[(22.52±6.54)、(15.12±2.63)ng/L](P＜0.05);IFN-γ/IL-4(3.27±1.45)、IFN-γ/IL-6(1.15±0.56)明显低于对照组(6.89±1.68、2.54±1.03)(P＜0.01或＜0.05).结论 EM患者有Th2细胞因子明显增多并占优势漂移的现象,Th1/Th2细胞因子失衡在EM的发病机制及疾病进展中可能具有重要的作用.

Abstract：

Objective To study the changes of interferon ( IFN )- γ ,interleukin(IL)-4 and IL-6 in endometriosis. Method The levels of peripheral blood IFN-γ ,IL-4 and IL-6 in 25 patients with endometriosis (EM group) and 20 normal adults (control group) were detected by enzyme linked immunosorbent assay (ELISA). Results The level of peripheral blood IFN- γ in EM group [(109.64±26.79 ) ng/L] was lower than that in control group [(155.17±30.36) ng/L] (P ＜ 0.05 ), IL-4[(33.52 ± 8.69)ng/L]and IL-6 [(44.12 ± 3.57) ng/L] were higher than those in control group [(22.52 ± 6.54), ( 15.12 ±2.63 )ng/L](P＜0.05 ).The ratio of IFN-γ/II-4(3.27±1.45 ) and IFN- γ/IL-6 ( 1.15 ± 0.56 ) in EM group were significantly lower than those in control group (6.89 ±1.68,2.54 ±1.03)(P ＜0.01 or ＜0.05).Conclusions Th1 cells shift toward Th2 cells in patients with endometriosis. Th1/Th2 ratio may be correlated with the pathogenesis of endometriosis.     

尘肺病患者外周血维生素D与淋巴细胞亚群、炎症因子的相关性研究

  目的  了解尘肺病患者的维生素D水平,并分析维生素D与炎症因子、淋巴细胞亚群各指标之间的相关性。
  方法  选取60名老年男性健康体检人员为对照组,182名尘肺病患者为研究组,比较两组的维生素D水平;同时分析研究组维生素D水平、尘肺病期别与炎症因子、淋巴细胞亚群的相关性。
  结果  182名尘肺病患者维生素D缺乏人员的占比高于对照组（P < 0.05）。研究组平均25（OH）D水平为（21.55 ±9.51）ng/mL,显著低于对照组的（27.16 ±8.12）ng/mL（P < 0.01）。182名尘肺病患者的炎症因子,包括白介素2受体（IL-2R）、白介素-6（IL-6）、白介素-8（IL-8）、降钙素原（PCT）、C反应蛋白（CRP）随着尘肺病期别的升高而升高（P < 0.05）;IL-6在维生素D充足组最低（P < 0.05）,IL-8、PCT及CRP随着25（OH）D水平的升高逐渐降低（P < 0.05）;壹期尘肺病患者CD4/CD8值高于贰、叁期患者（P < 0.05）,CD4 +T细胞、L/CD45随着尘肺分期的升高而降低（P < 0.05）;随着25（OH）D水平的升高,CD4 +T细胞占比、L/CD45逐渐升高,而CD8 +T细胞逐渐下降;25（OH）D与CRP水平呈弱的负相关（r=-0.191,P < 0.05）,25（OH）D与IL-10、CD4/CD8值、L/CD45呈弱的正相关（r=0.299、0.176、0.257,P < 0.05）。
  结论  尘肺病患者维生素D缺乏或不足率较高,尘肺病患者体内的维生素D可能通过调节炎症因子及细胞因子参与炎症反应及免疫功能。
     

哮喘患儿血清T细胞亚群、细胞因子和免疫球蛋白的动态变化及意义

目的 探讨哮喘患儿血清T细胞亚群、细胞因子和免疫球蛋白的动态变化及临床意义,为哮喘的发病机制及抗变态反应治疗提供理论依据.方法 对40例哮喘患儿(哮喘发作组和哮喘缓解组)及25例健康体检儿童(对照组)应用流式细胞仪测定CD3+、CD4+、CD8+T细胞,应用ELISA法测定TNF-α、白细胞介素(IL)-6、IL-8和IgE,应用免疫比浊法测定Igc、IgA和IgM.结果 哮喘发作组CD3+、CD4+T细胞及CD4+/CD8+.显著高于对照组(P＜0.01),CD4+T细胞及CD4+/CD8+明显高于哮喘缓解组(P＜0.05);哮喘缓解组CD4+T细胞及CD4+/CD8+明显高于对照组(P＜0.05).哮喘发作组IL-6、IL-8及TNF-α.均明显高于哮喘缓解组和对照组(P＜0.05或＜0.01).哮喘缓解组TNF-α与对照组比较差异有统计学意义(P＜0.05).哮喘发作组I-E及IgG水平显著高于哮喘缓解组和对照组(P＜0.01或＜0.05),IgA水平显著低于对照组(P＜0.01);哮喘缓解组IgE水平仍显著高于对照组(P＜0.01).结论 哮喘患儿发作期和缓解期均存在免疫失衡,提示哮喘患儿应长期抗变态反应治疗.     

脓毒症患者CD4+CD25+调节性T细胞的变化及其与预后的关系

目的 评价脓毒症患者外周血中CD4+CD25+调节性T细胞的变化趋势及其与预后的相关性.方法 采用流式细胞仪检测36例脓毒症患者自诊断成立第1、3、5天的CD4+CD25+细胞/CD4+细胞比值,并与15例健康体检者(对照组)比较.按照预后分为生存组和死亡组,分析两组CD4+CD25+调节性T细胞随时间的变化.结果 脓毒症患者19例生存,17例死亡.生存组和死亡组第1天CD4+CD25+细胞/CD4+细胞比值均低于对照组[分别为(12.42±3.26)%、(12.96±3.00)%比(16.97±3.66)%.P＜0.05].生存组和死亡组第3天CD4+CD25+s细胞/CD4+细胞比值分别为(24.47±4.62)%和(26.61±3.85)%.均高于第1天,差异有统计学意义(P＜0.05).生存组第5天CD4+CD25+细胞/CD4+细胞比值为(18.28±4.28)%,较第3天显著下降,差异有统计学意义(P＜0.05);死亡组第5天CD4+CD25+细胞/CD4+细胞比值为(36.19±5.33)%,较第3天显著升高,差异有统计学意义(P＜0.05).第1、3天生存组和死亡组比较差异均无统计学意义(P＞0.05);第5天生存组CD4+CD25+细胞/CD4+细胞比值显著低于死亡组(P＜0.05).结论 脓毒症患者血中CD4+CD25+调节性T细胞呈现先下降后上升的变化,而持续上升提示出现免疫功能麻痹,伴随病死率的升高.CD4+CD25+调节性T细胞可作为临床评价脓毒症患者炎性反应中免疫功能状态和预后的方便可靠的指标.     

肺炎支原体肺炎患儿血清细胞因子、高敏C反应蛋白、总免疫球蛋白及补体C的检测及其临床意义

目的 探讨检测肺炎支原体肺炎(MPP)患儿血清白细胞介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α、高敏C-反应蛋白(hs-CRP)、总免疫球蛋白(Ig)、补体C的临床意义.方法 选择61例MPP患儿(观察组)和60例健康儿童(对照组)为研究对象,IL-6、IL-8采用酶联免疫吸附试验方法测定,TNF-α采用γ放射免疫计数器检测,hs-CRP、总Ig、补体C采用速率散射比浊法测定.结果 观察组血清IL-6为(109.31±54.72)ng/L、IL-8为(128.19±65.87)ng/L、血清hs-CRP为(34.13±19.21)mg/L、总Ig为(12.62±5.51)g/L、补体C为(2.98±0.97)g/L,与对照组的(67.23±32.18)ng/L、(31.78±8.91)ng/L、(1.62±1.34)g/L、(6.71±3.65)g/L、(1.46±0.45)g/L比较均显著上升,差异有统计学意义(P＜0.05或＜0.01);两组血清TNF-α水平差异无统计学意义(P＞0.05).结论 IL-6、IL-8、hs-CRP、总Ig及补体C在小儿MPP中起重要作用,检测IL-6、IL-8、hs-CRP、总Ig及补体C的变化对判定病情和预后有一定的临床应用价值.

Abstract：

Objective To investigate the clinical significance of serum interleukin (IL)-6,IL-8,tumor necrosis factor (TNF)- α, high-sensitivity C-reactive protein (hs-C RP), total immunoglobulin (Ig) and complement C levels in children with mycoplasma pneumoniae pneumonia (MPP). Methods Sixty-one cases of children with MPP (observation group) and 60 healthy children (control group) were selected. The serum IL-6 and IL-8 levels were tested by enzyme linked immunosorbent assay(ELISA) method; the serum TNF-α level was tested by γ radioimmunoassay (RIA) counter; the serum hs-CRP, total Ig and complement C levels were tested by rate nephelometry method. Results The serum IL-6 concentration was (109.31 ±54.72) ng/L, IL-8 concentration was (128.19 ±65.87) ng/L, hs-CRP concentration was (34.13 ± 19.21) mg/L, total Ig concentration was (12.62 ± 5.51) g/L and complement C concentration was (2.98 ± 0.97) g/L in the observation group, and they were higher than those in the control group [(67.23 ±32.18) ng/L, (31.78 ±8.91) ng/L, (1.62 ±1.34) g/L, (6.71 ±3.65) g/L, (1.46 ±0.45) g/L]. The differences were significant (P ＜ 0.05 or ＜ 0.01). The serum TNF- t level between two groups had no significant difference (P＞ 0.05). Conclusions The serum cytokines IL-6 and IL-8, hs-CRP, total Ig and complement C play an important role in MPP. It has important significance to detect the serum cytokines IL-6 and IL-8, hs-CRP, total Ig and complement C levels in children with MPP.