急性呼吸窘迫综合征患者血浆白细胞介素4等含量变化的研究

目的　观察急性呼吸窘迫综合征 (ARDS)患者血浆白细胞介素 4(IL 4)、IL 10和IL 13含量的变化 ,探讨在ARDS发病机制中抗炎机制变化的意义。方法　采用酶联免疫吸附试验 (ELISA)方法 ,检测 2 2例ARDS患者 (ARDS组 )、8例全身炎症反应综合征 (SIRS)患者 (SIRS组 )和 10名健康志愿者 (正常对照组 )的动脉血血浆IL 4、IL 10和IL 13的含量。结果　ARDS组患者的血浆IL 4、IL 10和IL 13含量分别为 (2 61± 5 5 ) μg/L、(45 8± 112 ) μg/L、(5 2 1± 2 0 2 ) μg/L ,SIRS组分别为 (15 5± 2 6)μg/L、(2 60± 5 4) μg/L、(1 69± 0 3 9) μg/L ,正常对照组分别为 (43± 13 ) μg/L、(13 5± 15 ) μg/L、(0 3 3±0 10 ) μg/L ,三组间比较差异具有非常显著性 (P均 <0 0 1) ;SIRS组与正常对照组比较 ,差异也有显著性 (P <0 0 1)。结论　抗炎性细胞因子IL 4、IL 10和IL 13的释放异常 ,可能是ARDS和SIRS的重要发病机制之一。

Changes of plasma interleukin-4, interleukin-10 and interleukin-13 in patients with acute respiratory distress syndrome

OBJECTIVE: To explore the anti-inflammatory mechanisms of interleukin-4 (IL-4), interleukin-10 (IL-10) and interleukin-13 (IL-13) in acute respiratory distress syndrome (ARDS). METHODS: Enzyme-linked immunosorbent assay (ELISA) was employed to determine the plasma levels of IL-4, IL-10 and IL-13 in patients with ARDS (n = 22) and systemic inflammatory response syndrome (SIRS, n = 8). Ten normal subjects were enrolled as controls. RESULTS: The plasma levels of IL-4, IL-10 and IL-13 were (261 +/- 55) microg/L, (458 +/- 112) microg/L and (5.21 +/- 2.02) microg/L, respectively in patients with ARDS; (155 +/- 26) micro g/L, (260 +/- 54) microg/L and (1.69 +/- 0.39) microg/L respectively in patients with SIRS; and (43 +/- 13) microg/L, (135 +/- 15) microg/L and (0.33 +/- 0.10) microg/L, respectively in normal controls. They were significantly increased in patients with ARDS and SIRS as compared to normal controls, and the levels were higher in patients with ARDS than in patients with SIRS. CONCLUSIONS: Increased release of anti-inflammatory cytokines, such as IL-4, IL-10 and IL-13, may be one of the underlining mechanisms for the development of ARDS and SIRS.