儿童肺炎支原体肺炎血清中TNF-α、IL-6、IL-8和IL-10浓度测定及其临床意义的研究

目的:检测肺炎支原体(Mycoplasma pneumonia,MP)肺炎患儿血清中肿瘤坏死因子-a((Tumor necrosis fac-tor-a,TNF-a)、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-8(Interleukin-8,IL-8)和白细胞介素-10(Inter-leukin-10,IL-10)浓度的变化,探讨其与临床表现的相互关系。方法:应用ELISA双抗体夹心法对42例(实验组)肺炎支原体肺炎急性期患儿和34例(对照组)健康儿童血清中TNF-a、IL-6、IL-8和IL-10浓度进行检测。结果:肺炎支原体肺炎患儿血清中TNF-a、IL-6、IL-8和IL-10浓度明显高于对照组,统计学有显著性差异(P<0.01);而治疗后恢复期其浓度明显下降,但仍高于对照组,统计学无显著性差异(P>0.05);肺炎支原体肺炎有胸腔积液的患儿X线胸片检查出现肺部纤维化改变者,血清和胸水中TNF-a、IL-6、IL-8和IL-10浓度较肺部无纤维化改变者明显增高(P<0.01),胸片检查肺部无纤维化改变者,其血清与胸水中TNF-a、IL-8比较无显著性差异(P>0.05)。结论:TNF-a、IL-6、IL-8和IL-10在肺炎支原体肺炎的发生发展过程中起重要作用,与肺部有无纤维化形成关系十分密切,是肺炎支原体肺炎诊断的重要因素之一。检测肺炎支原体肺炎患儿血清中TNF-a、IL-6、IL-8和IL-10浓度的变化对临床诊断治疗和预后均有一定的临床实用价值。

Study on the clinical significance of serum TNF -a, IL -6, IL -8 and IL -10 concentration in children patients with mycoplasma pneumonia

Objective:To investigate the changes of concentration tumor necrosis factor-a(TNF-a),interleukik-6(IL-6),interleukik-8(IL-8)and interleukik-10(IL-10)in children with different clinical manifestations due to mycoplasma pneumoniae(MP) pneumonia and clinical significance.Methods:The concentration of TNF-a,IL-6,IL-8 and IL-10 were measured and determined by means of double-antibody sandwich enzyme-linked immunosobent assay(ELISA)in the serum of 42 children with Mycoplasmal pneumonia by clinical diagnosis and in 34 healthy children who were taken as the normal control group.Results:The concentration of TNF-a,IL-6,IL-8 and IL-10 were significant higher in severe mycoplasma pneumoniae before treatment or remission phase of after treatment than those in normal control group(P<0.01);After treatment concentrations of TNF-a,IL-6,IL-8 and IL-10 in the patients were not much different from those in the controls(P>0.05);In MP pneumonia patients with thoracic fluids,the concentration of TNF-a、IL-6、IL-8 and IL-10 in serum and pleural fluid of patients with fibrotic was higher than that of patients with no fibrotic(P<0.01),while there was no difference of the concentration of TNF-a and IL-8 between serum and the pleural fluids of patients with no fibrotic(P>0.05).Conclusion:TNF-a,IL-6,IL-8 and IL-10 may play an important role in the pathogenesis of the disease and may contribute largely to the development of the fibrotic change of the lung.Determination concentrations of TNF-a,IL-6,IL-8 and IL-10 the changes for diagnosis and treatment might be of important prognostic values in children with Mycoplasmal pneumonia.