68例急性白血病患者血清可溶性白细胞介素2受体水平测定

观察６８例急件白血病（ＡＬ）患者血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平，各型白血病均较对照组明显增高。ｓＩＬ－２Ｒ水平的变化与外周血原始细胞数呈相关，而与贫血、感染、血小板减少性出血及血中Ｔａｃ￣＋细胞数无关。ｓＩＬ－２Ｒ＞２０００Ｕ／ｍｌ者预后凶险。     

电转人IL－6受体基因在大鼠急性髓细胞白血病模型中的表达

应用平方波脉冲电转法将编码人ＩＬ－６受体的ｃＤＮＡ转入不表达ＩＬ－６Ｒ的ＢＮＭＬ大鼠急性早幼粒细胞白血病ＬＴ１２细胞中，转染细胞经含６００μｇ／ｍｌ的Ｇ４１８半固体。液体二步法培养，筛出Ｇ４１８抗性细胞；ＦＡＣＳ检测显示该细胞与ＦＩＴＣ标记的抗ＩＬ－６Ｒ单抗呈显著的荧光强度；￣（１２５）Ｉ－ＩＬ－６受体结合实验表明，ｋｄ＝４．７ｎｍ，每个细胞ＩＬ－６Ｒ数为４０００左右；Ｎｏｒｔｈｅｒｎ－Ｂｌｏｔ发现该细胞的ＲＮＡ与￣（３２）Ｐ标记的１．５ｋｂ的ＩＬ－６ＲｃＤＮＡ探针呈明显的杂交信号，证明我们已成功地建立了高表达人ＩＬ－６Ｒ的ＬＴ１２－ＩＬ－６Ｒ￣＋的大鼠急性白血病细胞模型。     

恶性血液病患者血清可溶性白细胞介素6受体水平的研究

目的：探讨恶性血液病患者血清可溶性白细胞介素６受体（ｓＩＬ－６Ｒ）的临床价值。方法：采用酶联免疫法测定２６例多发性骨髓瘤（ＭＭ）、３４例急性白血病（ＡＬ）、１７例非霍奇金淋巴瘤（ＮＨＬ）患者化疗前后及正常献血员的血清ｓＩＬ－６Ｒ水平。结果：初诊时血清ｓＩＬ－６Ｒ水平，ＭＭ患者较正常对照组显著增高（Ｐ〈０．００１），Ｂ细胞系急性淋巴细胞白血病（Ｂ－ＡＬＬ）患者亦高于正常对照（Ｐ〈０．０１），急性淋巴     

白血病患者白细胞介素6水平的改变及其临床意义

我们利用ＥＬＩＳＡ法研究了２４例性白血病患者的细胞诱生白细胞介素６（ＩＬ－６）水平的变化。结果表明，急性淋巴细胞性白血病（ＡＬＬ）和急性淋巴细胞性白血病（ＡＮＬＬ）患者的ＩＬ－６诱生水平明显高于正常对照组。而且ＩＬ－６在体外也可明显促进ＡＬＬ和ＡＮＬＬ细胞的增殖，提示ＩＬ－６可能参与了急性白血病的发生和发展过程。     

脐血清GM-CSF、IL-3和IL-6水平检测及意义

目的：探讨脐血的造血支持作用及其作用机理,为脐血的临床应用提供理论依据。方法：采用固相ＥＬＩＳＡ法检测３４例脐血清和２０例成人血清的ＧＭ－ＣＳＦ、ＩＬ－３和ＩＬ－６含量。结果：脐血清ＧＭ－ＣＳＦ、ＩＬ－３和ＩＬ－６含量分别为１９．１±１４．８、１９．２±１２．７和５７．５±２９．１ｐｇ／ｍｌ,成人血清ＧＭ－ＣＳＦ和ＩＬ－６未测出,ＩＬ－３含量为２．２±２．９ｐｇ／ｍｌ,差异均有极显著意义（Ｐ均＜０．００１）。结论：脐血含有丰富的造血生长因子,可用于再生障碍性贫血和化疗等原因引起的粒细胞减少的治疗。     

白细胞表面抗原CD4／CD8与白细胞介素在血液透析中的变化…

目的：探讨白细胞抗原ＣＤ４，ＣＤ８与白细胞介素（ＩＬ－２，ＩＬ－６，ＩＬ－８）在血液透析中的变化及其意义，方法：动态观察急性血液透析，维持性血透析和氮质血症患者透析前后ＣＤ４／ＣＤ８，ＩＬ－２，ＩＬ－６和ＩＬ－８水平。结果ＣＤ４／ＣＤ８和ＩＬ－２的急性透析者升高（Ｐ均〈０．０１），ＩＬ－２，ＩＬ－６和ＩＬ－４随代谢产物排泄而下降（Ｐ均〈０．０１），结论：ＣＤ４／ＣＤ８参与急性透析和维持性透析，ＩＬ     

紫外线照射对人外周血细胞凋亡的影响

目的　观察短波紫外线（ＵＶＣ） 照射正常人外周血单个核细胞凋亡及白细胞介素２（ＩＬ－ ２） 、ＩＬ－ １２ 水平的影响。方法　采用５０ ｍＪ／ｃｍ２ ,２００ ｍＪ／ｃｍ２ 和４００ ｍＪ／ｃｍ２ 不同剂量的ＵＶＣ照射人体外周血单个核细胞,培养２４ 小时后用双抗体夹心ＥＬＩＳＡ 法检测细胞凋亡及ＩＬ－ ２ 、ＩＬ－ １２的含量。结果　２００ ｍＪ／ｃｍ２ 、４００ ｍＪ／ｃｍ２ＵＶＣ 照射可明显诱发细胞凋亡（ｐｇ／ｍｌ） ,分别为４５ ．６８ ±１．３５,４６ ．６２ ±１．０２;照射后ＩＬ－ ２ 含量（ｐｇ／ｍｌ）明显下降（分别为１７６．８８±６ ．９７ ,１７４．１０ ±５ ．３６）,与对照组（ｓＡＰＯ－ １／Ｆａｓ ４１．０９ ±１ ．６９ ,ＩＬ－ ２ 为１９２．９８ ±１１．９７ ｐｇ／ｍｌ） 比较差异均有非常显著性（ Ｐ＜０．０１） ,而ＩＬ－ １２ 含量无明显变化。结论　ＵＶＣ 照射可诱发人外周血单个核细胞凋亡,此外凋亡可能是ＵＶＣ引起的ＩＬ－ ２ 缺失所致。     

白血病患者血清IL-8的测定

目的：探讨血清白细胞介素８（ＩＬ－８）变化在白血病中的意义。方法：采用平似酶联免疫吸附法测定了１０例急性淋巴细胞白血病（ＡＬＬ）,２５例急性非淋巴细胞白血病（ＡＮＬＬ）,１１例慢性粒细胞白血病（ＣＭＬ）慢性期血清ＩＬ－８浓度。结果：ＡＬＬ、ＡＮＬＬ和ＣＭＬ患者血清ＩＬ－８水平显著高于正常对照组,ＡＬＬ与ＡＮＬＬ患者无显著性差异,急性单细胞白血病组水平显著高于急粒白细胞病（Ｍ１￣Ｍ３）组,治疗有铲的     

全反式维甲酸治疗急性早幼粒细胞白血病血清IL—6水平的观察

全反式维甲酸治疗急性早幼粒细胞白血病血清ＩＬ－６水平的观察曾慧兰陶瑞芳张学光陈子兴夏学鸣孙爱宁王江方郑列琳张毅谢玮我们观察急性早幼粒细胞白血病（ＡＰＬ）患者在用全反式维甲酸（ＡＴＲＡ）治疗过程中血清白细胞介素６（ＩＬ－６）水平的变化，以探讨ＩＬ－６与...     

白介素—8水平的检测及其在评价腹透液生物相容性中的意义

为探讨持续性非卧床腹膜透析（ＣＡＰＤ）患者腹腔局部白细胞介素－８（ＩＬ－８）的基因表达及蛋白水平以及其在评价腹透液生物相容性中的临床意义。采用细胞原位杂交、逆转录－ＰＣＲ和酶联免疫吸附法（ＥＬＩＳＡ）检测６例非腹膜炎ＣＡＰＤ患者腹腔内巨噬细胞（ＭＰ）的表达和透出液中ＩＬ－８产生水平，以外周血清和外周淋巴细胞作自身对照。基因表达结果用计算机图象分析系统处理。结果显示腹腔内透析液ＩＬ－８水平明显高于血清（３９．２９±１６．３ｐｇ／ｍｌｖｓ２４．３２±１２．４ｐｇ／ｍｌＰ＜０．０５），腹腔巨噬细胞表达ＩＬ－８的信号也明显强于外周血淋巴细胞（３．２６±１．２１ｐｇ／ｍｌｖｓ１．３４±０．５８ｐｇ／ｍｌＰ＜０．０５）。结果表明在ＣＡＰＤ患者中，由于非生理性腹透液的长期刺激使腹腔巨噬细胞处于一种慢性激活状态并表达、释放ＩＬ－８，如监测透出液中ＩＬ－８水平可作为评价腹透液生物相容性的重要手段     

Proinflammatory cytokines in acute myocardial infarction with and without cardiogenic shock

BACKGROUND: Inflammatory response is an important feature of acute coronary syndromes and myocardial infarction (MI). The prognostic value of proinflammatory cytokines in patients with acute MI complicated by cardiogenic shock is unknown. METHODS AND RESULTS: In 41 patients admitted with acute MI (age 60 +/- 11 years, six females, 19 Killip class IV) serial plasma concentration of tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6) and interleukin 1 receptor antagonist (IL-1Ra) were measured. Seven patients with cardiogenic shock (CS) developed a systemic inflammatory response syndrome (SIRS). Patients with CS-particularly those who developed SIRS-showed significantly higher cytokine levels than patients with uncomplicated MI. In patients with CS and SIRS peak levels of IL-1Ra were 223,973 pg/ml, IL-6 252.8 pg/ml and TNF-alpha 7.0 pg/ml. In CS without SIRS IL-1Ra levels were 19,988 pg/ml, IL-6 109.3 pg/ml and TNF-alpha 3.8 pg/ml. In uncomplicated MI peak IL-1Ra levels were 1,088 pg/ml, IL-6 34.1 pg/ml and TNF-alpha 2.6 pg/ml. CONCLUSIONS: The inflammation-associated cytokines TNF-alpha, IL-6 and IL-1Ra are significantly elevated in patients with MI complicated by CS when compared to patients with uncomplicated MI. Among shock-patients IL-1Ra levels are promising diagnostic markers for early identification of patients developing SIRS, heralding a poor outcome.     

Sequential changes in plasma cytokine and endotoxin levels in cirrhotic patients with bacterial infection

To delineate the clinical roles of plasma cytokine or endotoxin levels in the natural course of infection in patients with decompensated cirrhosis, 66 cirrhotic patients were studied within a 1.5-year period. Plasma levels of tumour necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), IL-6, IL-8 and endotoxin were determined on days 1, 4 and 7 after admission when hospital infection was suspected and 4 months later. A total of 24 patients (36.4%) were proven to be infected during hospitalization (group A), while 42 others were not infected (group B). Fever occurred in a very high proportion (22/24) of group A patients. Baseline levels of TNF-alpha (37.7+/-15.2 compared with 8.7+/-1.2 pg/ml; P<0.01) and IL-6 (180.5+/-20.5 compared with 24.6+/-7.5 pg/ml; P<0.0001) were higher in group A patients, while IL-1beta, IL-8 and endotoxin levels were not significantly different between the two groups. For patients with hospital infection, IL-6 levels determined during the episode were significantly higher than baseline levels. Using IL-6 >80 pg/ml as a baseline cut-off level to diagnose bacterial infection, the sensitivity, specificity and accuracy were 87.5, 100 and 95.5% respectively. The one-year cumulative probability of mortality (61.1% compared with 23.7%; P<0.001) and of bacterial re-infection (72.2% compared with 18.4%; P<0.0001) was higher in group A than in group B. Plasma TNF-alpha and IL-6 levels determined at 4 months were not different between the two groups. In conclusion, fever or elevated plasma IL-6 levels in patients with decompensated cirrhosis calls for early antibiotic treatment to prevent life-threatening bacterial infection. Bacterial infection is likely to recur in those patients with increased IL-6 levels, while severe episodes of infection occur in patients with increased TNF-alpha levels.     

肺结核病人血清中IL-22和IL-17的表达水平及临床意义分析

目的研究肺结核病人血清IL-22和IL-17的表达水平并分析其临床意义。方法采用ELISA法检测59例肺结核患者(TB)和44例健康志愿者(HD)外周血清IL-22和IL-17的表达水平,同时检测了白细胞计数(WBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)的水平,并分析细胞因子之间及细胞因子与三项炎症指标的相关性。结果 TB组外周血清IL-22和IL-17的浓度分别为26.70±10.63pg/ml和128.02±6.96pg/ml,均显著高于HD组IL-22和IL-17的浓度(12.21±1.79pg/ml,109.07±3.02pg/ml,P0.05);使用常规化疗药物治疗后TB病人血清IL-22和IL-17的浓度分别为15.12±1.08pg/ml和115.63±2.98pg/ml,均显著低于治疗前IL-22和IL-17的浓度水平(26.70±10.63pg/ml,128.02±6.96pg/ml,P0.05);痰涂片TB菌检测阳性患者IL-22和IL-17的浓度分别为30.68±9.13pg/ml和131.67±4.96pg/ml,均显著高于痰涂片TB菌检测阴性患者的水平(19.89±2.54pg/ml,125.15±4.58pg/ml,P0.05)。Pearson相关性分析显示,TB患者外周血清IL-22的浓度和IL-17的浓度呈显著正相关(P0.05),且TB患者血清中IL-22和IL-17的浓度与ESR、CRP的水平均为正相关(P0.05),与WBC的水平无明显相关性(P0.05);痰涂片TB菌阳性患者血清IL-22的浓度和IL-17的浓度呈显著正相关(P0.05),且TB菌阳性患者血清IL-22和IL-17的浓度分别与WBC、ESR、CRP的水平均为正相关(P0.05)。结论 IL-22和IL-17在机体的抗结核免疫过程中发挥重要作用。     

系统性红斑狼疮患者血清IL-1家族多种细胞因子、拮抗剂及可溶性受体水平表达与疾病活动度的相关性研究

目的 分析系统性红斑狼疮（systemic lupus erythematosus,SLE）病人血清中IL-1家族细胞因子、拮抗剂与可溶性受体含量变化与临床价值。方法 选取泸州市中医医院于2018年6月～2020年6月期间收治的60例SLE病人为观察组,同期60例健康体检人员为对照组,另基于SLE疾病活动指数评分（SLEDAI）,划分观察组为活动组和稳定组。对比上述三组IL-1家族细胞因子、拮抗剂、可溶性受体含量,并对SLE患者细胞因子水平与免疫指标ds-DNA,补体C3,C4,C1q的相关性进行分析。结果 观察组与对照组比较,细胞因子IL-33[1.5(0～2.90) vs 0.2(0～1.46)]pg/ml,IL-18[329.2(271.5～386.2) vs 430.0(314.6～587.8)]pg/ml,拮抗剂IL-18BP[6 455(5 021～8 357) vs 9 863(6 982～15 746)]pg/ml,IL-1Ra[173.5(120.3～213.8)vs226.9(129.9～478.2)]pg/ml和可溶性受体IL-1R4[1004(7356～12 5...     

初诊活动性肺结核患者血浆IL-6，IL-17，IL-37及TIM-3水平表达及其临床意义

目的　探讨初诊肺结核患者血浆白细胞介素-6（IL-6）、白细胞介素-17（IL-17）、白细胞介素-37（IL-37）及T细胞免疫球蛋白黏蛋白分子-3(TIM-3)水平变化及其临床意义。方法　收集2018年1月～2020年10月百色市人民医院收治的活动性肺结核患者57例、肺炎患者50例和健康对照40例。57例肺结核患者中菌阳肺结核31例,菌阴肺结核26例。57例肺结核按病情轻重、病程长短及病变范围分为轻症组32例和重症组25例。采用酶联免疫吸附测定（ELISA）法检测各组血浆IL-6,IL-17,IL-37及TIM-3水平,并进行比较。结果　肺结核组血浆IL-6（41.37±13.50 pg/ml vs 26.28±9.16pg/ml,3.05±1.08 pg/ml）,IL-17（62.50±10.73pg/ml vs 30.47±7.18pg/ml,16.13±5.86pg/ml）,IL-37（14.63±4.18pg/ml vs 9.85±2.74pg/ml,4.10±1.02 pg/ml）及TIM-3（18.17±5.16ng/ml vs 11.80±3.52ng/ml,6.24±2.15 ng/ml）水平均明显高于肺炎组和对照组,差异均有统计学意义（t=7.338~13.273,均P＜0.001）。菌阳肺结核组血浆IL-6（52.60±15.71pg/ml vs 30.16±8.95 pg/ml）,IL-17（72.35±15.20 pg/ml vs 46.52±9.13 pg/ml）,IL-37（16.50±6.14 pg/ml vs 12.48±3.17 pg/ml）及TIM-3（21.70±7.93ng/ml vs 15.21±4.92 ng/ml）水平均明显高于菌阴肺结核组,差异具有统计学意义（t=8.472,10.161,6.925,9.106,均P＜0.001）。重症组血浆IL-6（56.38±17.26pg/ml vs 25.84±9.27pg/ml）,IL-17（79.50±16.38 pg/ml vs 48.20±8.74 pg/ml）,IL-37（18.48±6.20 pg/ml vs 10.82±3.26pg/ml）及TIM-3（23.26±8.15ng/ml vs 13.90±4.71ng/ml）水平明显高于轻症组,差异具有统计学意义（t=12.642,14.513,10.205,13.172,均P＜0.001）。结论　血浆IL-6,IL-17,IL-37及TIM-3水平在肺结核患者中明显升高,对判断肺结核严重程度有一定的价值。     

Net inflammatory capacity of human septic shock plasma evaluated by a monocyte-based target cell assay: identification of interleukin-10 as a major functional deactivator of human monocytes [published erratum appears in J Exp Med 1996 Nov 1;184(5):2075]

We have developed a functional assay to study the inflammatory capacity of plasma collected from patients with severe gram-negative septic shock. In this assay, elutriation-purified, cryo-preserved human monocytes from one healthy donor are combined with plasma from patients with severe persistent septic shock for 5 h. Subsequently, the plasma is removed, medium added, and procoagulant activity (PCA) and secretion of tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) measured after 18-h incubation. Plasma from 10 patients (6 died) infected with Neisseria meningitidis previously shown to contain high levels of native lipopolysaccharide (LPS) (median 2,700 pg/ml), TNF- alpha, IL-6, IL-8, and complement activation products, had a low net spontaneous inflammatory capacity on the monocytes. The median levels of PCA, TNF-alpha, and IL-6 were 5, 0, and 4%, respectively, of the monocyte activities induced by normal plasma boosted with purified N. meningitidis (Nm)-LPS (2,500 pg/ml; net LPS-boosted capacity, 100%). The levels of PCA, TNF-alpha, and IL-6 obtained with plasma from shock patients were not different from those induced by plasma from 10 meningococcal patients without shock or with plasma from healthy persons. Boosting shock plasma with 2,500 pg/ml Nm-LPS had little effect on the monocyte activities since the median values of PCA, TNF- alpha, and IL-6 revealed a minimal increase from 5, 0, and 4% to 9, 2, and 6%, respectively. The shock plasmas revealed a strong LPS- inhibitory capacity that was largely absent in plasmas from 10 meningococcal patients without shock since the median levels of PCA, TNF-alpha, and IL-6 increased from 5, 0, and 0% to 135, 51, and 73%, respectively, after boosting with 2,500 pg/ml Nm-LPS. The LPS- inhibitory capacity was closely associated with the levels of IL-10. The median levels of IL-10 were 19,000 pg/ml in nine shock patients vs. 22 pg/ml in nine nonshock patients with systemic meningococcal disease. Removal of native IL-10 by immunoprecipitation restored the capacity of plasmas to induce monocyte activation either by native LPS or by boosting with Nm-LPS. IL-4 and TGF-beta were not detected in shock plasmas. In 24 patients with detectable meningococcal LPS ( > 10 pg/ml, 0.1 endotoxin units/ml), the levels of IL-10 were correlated to the levels of LPS (r = 0.79, P < 0.001). IL-10 declined from initiation of antibiotic therapy and paralleled the levels of native LPS. Decreasing levels of IL-10 in serially collected shock plasmas were directly related to increasing monocyte responsiveness after Nm-LPS boosting. These results suggest that IL-10 plays a major role in containing activation of monocytes and possibly other LPS-responsive cells during overwhelming meningococcemia.     

Amniotic fluid interleukin 6 in preterm labor. Association with infection.

To evaluate whether IL-6 participates in the host response to intrauterine infection, we studied IL-6 bioactivity and isoforms in amniotic fluid (AF). Two different assays for IL-6 were used: the hepatocyte stimulating factor assay (in Hep3B2 cells) and the SDS-PAGE/immunoblot assay. IL-6 determinations were performed in 205 AF samples. Samples were obtained from patients in the midtrimester of pregnancy (n = 25), at term with no labor (n = 31), at term in active labor (n = 40), and from patients in preterm labor (n = 109). Higher AF IL-6 levels were observed in women in preterm labor with intraamniotic infection than in women in preterm labor without intraamniotic infection (median = 375 ng/ml, range = 30-5000 ng/ml vs. median = 1.5 ng/ml, range = 0-500, respectively, P less than 0.0001). The 23-25- and 28-30-kD IL-6 species could be readily detected in SDS-PAGE immunoblots performed directly on 10-microliters aliquots of AF from patients with intraamniotic infection. Among women in preterm labor with culture-negative AF, those who failed to respond to subsequent tocolytic treatment had higher AF IL-6 concentrations than those who responded to therapy (median = 50 ng/ml vs. median = 1.2 ng/ml, respectively, P less than 0.05). Only low levels of IL-6 were detected in AF obtained from normal women in the midtrimester and third trimester of pregnancy. Decidual tissue explants obtained from the placentas of women undergoing elective cesarean section at term without labor (n = 11) produced IL-6 in response to bacterial endotoxin. In a pilot study, AF IL-6 was determined in 56 consecutive women admitted with preterm labor. All patients (n = 10) with elevated AF IL-6 (cutoff = 46 ng/ml) delivered a premature neonate. 4 of these 10 patients had positive AF cultures for microorganisms. These studies implicate IL-6 in the host response to intrauterine infection and suggest that evaluation of AF IL-6 levels may have diagnostic and prognostic value in the management of women in preterm labor.     

Resource utilization and cost of episodes of febrile neutropenia in children with acute leukemias and lymphomas

The resource utilization and cost of 51 episodes of febrile neutropenia in children with leukemia and lymphomas who were admitted to the Pediatric Oncology Institute (GRAAC) of the Federal University of S?o Paulo were analyzed. Patients aged 60 days to 21 years with confirmed diagnoses of acute myeloid leukemia, acute lymphoid leukemia, non-Hodgkin lymphoma, or Hodgkińs disease who presented axillary temperature above 38 degrees C at least once episode, or between 37.5 degrees C and 38 degrees C on three occasions during a 24-h period, neutrophil count below 500/mm(3), or between 500/mm(3)and 1,000/mm(3) but expected to fall below 500/mm(3) were included in the study. The patients' ages varied between 1 and 15.6 years, and 67% of the patients were male. The median cost per treated episode was US dollars 2,660 (2,039). Hospitalization costs accounted for 62% of the total cost of the treatment, antibacterials accounting for 23%. Episodes in patients with documented infections had a higher median direct cost than episodes in patients with fever of unknown origin (P=0.018). There was a trend for a higher median direct cost in episodes among patients with a worse prognostic factor, such as type of underlying disease, presence of documented infection, and longer duration of neutropenia. This is the first study to evaluate the economics of febrile neutropenia episodes in Brazil, and serves as a basis for resource utilization and costs incurred in the treatment of such patients in this country.     

类风湿关节炎患者血清白细胞介素-21水平检测及临床意义

目的检测类风湿关节炎(RA)患者血清中白细胞介素-21(IL-21)的水平,分析其临床意义。方法收集RA患者76例,采用双抗体夹心酶联免疫吸附试验(ELISA)检测RA患者及37例正常对照者血清IL-21水平,并分析血清IL-21水平与RA各临床及实验室指标的相关性。计量资料的比较采用Mann-Whitney U检验或单因素方差分析,相关性分析采用Spearman相关分析。结果 RA患者血清IL-21水平为86.5(64.1～130.1)pg/ml,明显高于正常对照组[65.0(40.0～90.3)pg/ml],差异有统计学意义(U=957.5,P=0.006);类风湿因子(RF)三个亚型IgM、IgA、IgG及抗环瓜氨酸肽(CCP)抗体阳性组RA患者血清IL-21水平与其自身抗体均呈正相关(r分别为0.300、0.382、0.370、0.372;P均<0.05)。RA患者RF(IgM、IgA)、CCP抗体阳性组血清IL-21水平显著高于阴性组[82.2(57.0～126.1)pg/ml]和76.9(52.0～201.4)pg/ml,U=176.5,P=0.024;95.4(62.1～144.6)pg/ml和70.6(43.0～110.8)pg/ml,U=282.5,P=0.016;82.9(51.0～145.1)pg/ml和76.5(63.4～144.6)pg/ml,U=333.0,P=0.031],差异有统计学意义。患者血清IL-21水平与触痛关节数(TEN28)及肿胀关节数(SW28)均呈正相关(r分别为0.342、0.200;P均<0.05),但IL-21与DAS28评分、C-反应蛋白、血沉、年龄、病程等均无明显相关性。结论 IL-21在RA患者血清中高表达,并与RF、抗CCP抗体密切相关,提示IL-21可能是RA发病机制的环节之一。     

Serum interleukin-6 concentrations as predictive factor of time to progression in metastatic malignant melanoma patients treated by biochemotherapy: a retrospective study

This retrospective study sought to evaluate the impact of IL-6 concentration on time to progression in advanced melanoma. One hundred and thirty-five patients were included, serum IL-6 levels were determined before (Day 0), at the end of the treatment (Day 49) and at recurrence: the relationship between IL-6 concentration and time to progression (TTP) was also evaluated. The baseline median serum IL-6 level was 16.5 pg/ml. When disease progression was observed, an increase in serum IL-6 level was noted. In order to establish the possible relationship between IL-6 level and TTP, patients were divided into two groups (low and high) using the median IL-6 level (16.5 pg/ml) detected in the pretreatment serum of overall patients as a cut-off. Sixty patients were in the low IL-6 group and 56 patients in the high IL-6 group. Time to progression was calculated from the beginning of treatment to recurrence, and analyzed using the Kaplan-Meier method. Patients with low IL-6 serum concentration showed a significantly (p<0.00001) higher median TTP than patients with high IL-6 level. Patients maintaining a low IL-6 level during the treatment showed the longest median TTP compared with those supporting high levels (24.4 versus 5.5 months). Taken together, our results showed that serum IL-6 level could be considered a predictive marker of recurrent disease in metastatic malignant melanoma.