特发性肺纤维化患者肺泡灌洗液及血清中白细胞介素4、12水平变化的意义

目的探讨特发性肺纤维化（IPF）患者肺泡灌洗液及血清中自细胞介素4、12（IL-4、IL-12）水平变化的意义。方法用酶联免疫吸附法,检测30例IPF患者（IPF组）血清及支气管肺泡灌洗液（BALF）中IL-4、IL-12的水平;健康非吸烟的自愿献血者30名,为血清对照组,检测其血清IL4、IL-12的水平;以胸痛为主诉进行BALF检查证实为健康者9名,作为BALF对照组,检测其BALF中IL-4、IL-12的水平。结果IPF组患者BALF中IL-4为（84．87±26．10）pg／ml、IL-12为（12．33±6．89）pg／ml,对照组BALF中IL-4、IL-12分别为（55．78±22．88）、（46．674-24．67）pg／ml,两组相比差异有显著意义（P值均〈0．01）;IPF组患者血清IL-4水平的变化与BLAF一致,但血清IL-12为（45．70±25．65）pg／ml,与血清对照组（46．80±23．73）pg／ml相比差异无显著性（P〉0．05）。结论IPF时Th1型细胞因子IL-12水平下降主要发生在肺组织局部,而Th2型细胞因子IL-4水平增高的变化是一种全身性行为,TH1／Th2型细胞因子平衡失调,在IPF的发生、发展过程中起着重要的作用。

Chang of interleukin-4, interleukin-12 in the bronchoalveolar lavage fluid and the serum of the patients with idiopathic pulmonary fibrosis and their clinical significance

Objective To detect the levels of interleckin-4 （IL-4）, IL-12 in the bronchoalveolar lavage fluid （BALF） and the serum of patients with idiopathic pulmonary fibrosis （IPF） and to investigate the significance of their change in the pathogenesis of IPF. Methods Enzyme-linked immuneadsordent assay （ELISA） were used to detect the levels of IL-4, IL-12 in the BALF and the serum of patients with IPF and 9 subjects with non-interstitial lung diseases （non-smoker）. Results In the BALF of patients with IPF, the levels of IL-4 （84. 87±26. 10） pg/ml were higher than that of the control group （P 〈0. 01 ）, and the level of IL-12 （ 12.33±6.89） pg/ml was lower than that of the control group. In the patients with IPF, the change of IL-4 in the serum was consistent with the change in the BALK But the levels of IL-12 （45.70±25.65 ） pg/ml showed no significant difference between the patients with IPF and the control group. Conclusion Decrease of cytokine IL-12 is local pulmonary reaction, but the increase of IL-4 is systemic. The proportional disequilibrium of Thl and Th2 cytokine play important role in the process of IPF.