白细胞介素6及其基因启动子多态性在儿童急性阑尾炎中的表现

目的①研究血清、腹腔渗液中自细胞介素6（interleukin-6，IL-6）的水平在小儿急性阑尾炎诊断及严重程度分型中的价值；②探讨IL-6基因启动子-174G／C、-572G／C位点的多态性与小儿急性阑尾炎严重程度的关系。方法选取101例急性阑尾炎患儿，依据病理诊断分为普通组（单纯／化脓）、重症组（坏疽／穿孔）两组，以健康儿童为对照，ELISA法检测血清及腹腔渗液中IL-6浓度，用PCR-RFLP并测序法确定IL-6基因启动子的基因型。应用SPSS10．0统计软件对原始数据进行统计学处理。结果①普通组及重症组血IL-6浓度均明显高于对照组，P〈0．01；重症组血IL-6浓度明显高于普通组P〈0．01；重症组腹腔渗液IL-6、血C反应蛋白的浓度明显高于普通组，发病时间明显长于普通组，P〈0．01。②重症组-572CC型频率明显高于普通组，P=0．011；三组间-174位点基因型频率的差异无显著性意义。③重症组及对照组-572CC型患儿血清IL-6表达水平明显高于-572G携带型，P〈0．05；普通组-572CC型血清IL-6的表达水平高于-572G携带者，P=0．056。④logistic regression多因素分析结果表明-572位点的基因型、发病时间（症状出现至手术）与重症阑尾炎的发生有关。结论①IL-6有助于小儿急性阑尾炎的诊断及严重程度分型。但非急性阑尾炎或急性重症阑尾炎的特异性检测指标；②IL-6基因启动子-572位点CC型与小儿重症阑尾炎发生有关，IL-6基因-572C等位基因调控转录及表达的具体机制尚需进一步研究。

Interleukin-6 and its gene promoter polymorphisms in children with acute appendicitis

Objective To evaluate interleukin-6(IL-6) level and its gene promoter polymorphisms in different pathological types of acute appendicitis in children.Methods We recruited 101 children with acute appendicitis and a control group from healthy children.The patients were divided into two groups based on pathological diagnosis: complicated group with gangrene or perforation of the appendix,and uncomplicated group with other pathological types.The concentrations of IL-6 in plasma and peritoneal fluid were determined by ELISA.And IL-6 gene promoter polymorphisms(-174G/C and-572G/C) were genotyped by PCR-RFLP and auto-sequencing.Results Plasma concentration of IL-6 in patients,either in complicated group or in uncomplicated group,was significantly higher than that in control group.Concentrations of IL-6 in plasma and peritoneal fluid in complicated group were significantly higher than those in uncomplicated group.Moreover,the frequency of-572CC genotype in complicated group((83.3%)) was significantly higher than that in uncomplicated group ((58.5%)).There were no significant differences among the patient groups or between patient and control group in the frequency of polymorphisms of IL-6 gene promoter-174G/C.In complicated group and in control group,plasma concentrations of IL-6 in genotyping-572CC was significantly higher than that of-572G carriers(P<(0.05)).And the logistic regression analysis showed that the complicated appendicitis was associated with IL-6 gene promoter-572 polymorphisms.Conclusions The complicated acute appendicitis was associated with IL-6 gene promoter-572 CC genotype.And detecting plasma IL-6 is helpful in differentiating complicated acute appendicitis from uncomplicated ones in children.