急性心肌梗塞病人血清sIL—2R水平,mIL—2R和T淋巴细胞亚群的变化

目的探讨急性心肌梗塞发病中免疫指标的变化。方法应用单克隆与多克隆双抗体夹心法检测６６例急性心肌梗塞（ＡＭＩ）病人发病后第１周内血清可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）的变化，同时检测外周血淋巴细胞膜白细胞介素－２受体（ｍＩＬ－２Ｒ）表达及Ｔ淋巴细胞亚群的变化。结果ＡＭＩ病人血清ｓＩＬ－２Ｒ明显增高，ｍＩＬ－２Ｒ表达明显降低，与对照组比较差异有极显著性意义（Ｐ＜０．００１）。发病后第１ｄ至第７ｄ，ｓＩＬ－２Ｒ增高和ｍＩＬ－２Ｒ表达降低一直比较明显。ＡＭＩ病人ＣＤ４、ＣＤ８和ＣＤ４／ＣＤ８明显低于对照组（Ｐ＜０．００１），以第１ｄ降低最明显，以后逐渐升高，ＣＤ８于第７ｄ恢复正常。４ｄ内死亡者和伴有室性心律失常（ＶＡ）者上述指标变化更明显。结论血清ｓＩＬ－２Ｒ水平、ｍＩＬ－２Ｒ表达和Ｔ淋巴细胞亚群变化与ＡＭＩ病情和预后有密切关系。     

病毒性心肌炎可溶性白细胞介素2受体、自然杀伤细胞活性及T细胞亚群的检测

应用单克隆与多克隆双抗体夹心法检测３６例病毒性心肌炎（ＶＭＣ）及２４例正常人（ＮＣ）的血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ），同时测定外周血自然杀伤细胞（ＮＫＣ）活性和Ｔ淋巴细胞亚群。结果显示ＶＭＣ患者ｓＩＬ－２Ｒ明显高于ＮＣ组（Ｐ＜０．００１）．而ＮＫＣ活性明显低于ＮＣ组（Ｐ＜０．０１），Ｔ细胞亚群与ＮＣ组比较，急性ＶＭＣ患者总Ｔ细胞（ＣＤ３），辅助性Ｔ细胞（ＣＤ４）和抑制性Ｔ细胞（ＣＤ８）均减少，ＣＤ４／ＣＤ８比值显著降低（Ｐ＜０．０５．０．０１），以细胞免疫功能低下为明显；而ＶＭＣ后遗症期患者ＣＤ３、ＣＤ４与ＮＣ组无差异（Ｐ＞０．０５），ＣＤ８显著降低（Ｐ＜０．０５），ＣＤ４／ＣＤ８比值显著高于ＮＣ组（Ｐ＜０．０５），以细胞免疫调节失衡为主。上述结果提示细胞免疫功能低下及免疫功能失调为ＶＭＣ发病及影响预后的重要因素。     

老年肺部疾病患者血清sIL-2R水平和T淋巴细胞亚群的研究

目的：探讨老年肺疾患者血清可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）浓度和Ｔ细胞亚群的关系。方法采用双抗体夹心ＥＬＩＳＡ法和碱性磷酸酶抗碱性磷酸酶（ＡＰＡＡＰ）法。结果肺疾患各组ｓＩＬ－２Ｒ水平升高均高于对照组（Ｐ〈０．００１）。其中以肺癌组ｓＩＬ－２Ｒ水平升高最显著,与肺良性疾病组比较亦有显著差异（Ｐ〈０．００１）。肺疾患组的ＣＤ４低于对照组（Ｐ〈０．０５）。结论ｓＩＬ－２Ｒ和Ｔ细胞亚群可作为肺疾     

环孢霉素A治疗狼疮性肾炎对血尿可溶性白介素2受体的影响

本文观察环孢霉素（ＣｓＡ）治疗１６例重症ＬＮ患者，对血尿可溶性白介素２受体（ＳＩＬ－２Ｒ）及外周血Ｔ淋巴细胞亚群（ＣＤ４＋／ＣＤ８＋细胞）的影响。结果ＣｓＡ治疗后，ＬＮ患者血尿ＳＩＬ－２Ｒ均有明显下降（Ｐ＜０．０１），外周血ＣＤ４＋细胞亦有下降趋势；同时伴有血清免疫学异常及临床肾损害的明显改善。本文提示ＳＩＬ－２Ｒ可作为ＬＮ活动度的一项敏感指标；ＣｓＡ可能通过抑制Ｔ淋巴细胞活性，减少被激活的淋巴细胞释放ＳＩＬ－２Ｒ，从而取得治疗ＬＮ的良好疗效。     

乙型肝炎患者外周血T细胞亚群和可溶性IL_2R的研究

目的探讨急慢性乙型肝炎患者外周血Ｔ细胞亚群及可溶性ＩＬ＿２Ｒ水平的变化，为诊断病情演变和预后判定寻找可靠的依据．方法应用ＡＰＡＡＰ桥联酶标法和双抗体夹心ＥＬＩＳＡ法检测正常人３０例和各型乙型肝炎患者１７５例的Ｔ细胞亚群变化和血清可溶性ＩＬ＿２Ｒ（ｓＩＬ＿２Ｒ）水平．结果各组乙肝患者ＣＤ３，ＣＤ４，ＣＤ４／ＣＤ８比值明显降低，ＣＤ８则明显升高．乙肝患者血清ｓＩＬ＿２Ｒ水平均显著升高，其中慢重肝、肝硬变、急性乙肝和慢性肝炎增高最为显著，与正常对照组相比Ｐ均＜００１，且与ＨＢＶ复制有关．结论乙型肝炎患者存在Ｔ细胞比例失衡，血清ｓＩＬ＿２Ｒ水平均明显增高，其水平与机体免疫功能状态及肝细胞损伤程度相关．     

肝硬化和肝细胞癌患者血清IL-2、sIL-2R、IL-6、T细胞亚群的变化及相互关系

目的研究肝硬化和肝细胞癌患者ＩＬ－２、ｓＩＬ－２Ｒ、ＩＬ－６、Ｔ细胞亚群的变化和相互关系。方法分别采用双抗体夹心ＥＬＩＳＡ法、ＡＢＳ－ＥＬＩＳＡ法和红细胞花环实验,对４６例肝炎肝硬化和肝癌进行了ＩＬ－２、ＩＬ－６、ｓＩＬ－２Ｒ和Ｔ细胞亚群的测定,并与６６例健康献血员进行了对照。结果肝炎肝硬化（ＬＣ）、肝细胞癌（ＨＣＣ）患者血清ＩＬ－２、ＣＤ＋４／ＣＤ＋８水平明显低于正常对照（ＮＣ）组（Ｐ＜００１）,而ＩＬ－６、ｓＩＬ－２Ｒ水平明显升高,ＨＣＣ组的平均ＩＬ－６水平高出正常１０倍以上,较肝硬化组明显升高（Ｐ＜００１）。在肝炎肝硬化和肝癌患者均发现ＩＬ－２与ＣＤ＋４／ＣＤ＋８比值、ＩＬ－６与ｓＩＬ－２Ｒ正相关,ＩＬ－６与ＣＤ＋４／ＣＤ＋８比值显著负相关,而与ＩＬ－２无相关关系。结论肝炎肝硬化和肝细胞癌患者存在免疫功能紊乱和低下、淋巴因子网络失衡,这与其病理生理机制有关,也为临床上ＬＣ、ＨＣＣ应用ＩＬ－２治疗提供了理论依据。ＩＬ－６的显著增高有助于ＨＣＣ的早期诊断     

结核病白细胞介素2受体测定和T细胞亚群分析的临床意义

采用间接酶联免疫吸附（ＥＬＩＳＡ）法检测了３９例浸润型肺结核患者的血清和尿液可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）浓度，用单克隆抗体间接免疫荧光法检测了其Ｔ细胞亚群；并与２８例健康人作正常对照。结果显示：①结核病活动期组血清及尿液ＳＩＬ－２Ｒ浓度明显高于康复期组（Ｐ＜０．０５）和对照组（Ｐ＜０．０５），而结核病康复期组血清及尿液ＳＩＬ－２Ｒ浓度与对照组间差异无显著意义（Ｐ＞０．０５）。②结核病活动期组尿液与血清ＳＩＬ－２Ｒ浓度呈正相关（Ｐ＜０．０１）。③结核病活动期组ＣＤ＋４Ｔ细胞数及ＣＤ＋４／ＣＤ＋８Ｔ细胞比值明显低于康复期组和对照组（Ｐ均＜０．０１）。提示结核病活动期患者Ｔ细胞免疫应答能力降低，ＳＩＬ－２Ｒ浓度升高可作为结核病活动期指标之一。     

冬虫夏草多糖脂质体对肝炎后肝硬化患者T细胞免疫调节作用的研究

应用脂质体包埋冬虫夏草多糖口服３个月治疗肝炎后肝硬化２８例，在治疗前、后第２、３个月分别检测外周血Ｔ细胞免疫功能指标和肝功能。结果：①ＰＨＣ患者外周血ＣＤ４细胞比例，ＣＤ４／ＣＤ８比值、自然杀伤细胞活性及经ＰＨＡ－Ｐ诱导的外周血淋巴细胞、膜白细胞介素２受体（ＭＩＬ－２Ｒ）的表达，白细胞介素２（ＩＬ－２）和＋γ－干扰素（ＴＦＮ－γ）的生成均显著低于正常对照（Ｐ值分别＜０．００１，＜０．０１，＜０．０     

未经治疗的原发性肝癌患者的免疫功能状态

对２８例未经任何治疗的中晚期原发性肝癌患者进行免疫功能的检测，并与正常比较，结果发现其ＩＬ－２系统中ＩＬ－２产生能力显著性降低，Ｔ淋巴细胞ｍＩＬ－２Ｒ表达非常显著性降低，而血清ｓＩＬ－２Ｒ水平非常显著性增加；外周血淋巴细胞绝对数及Ｔ淋巴细胞亚群分析表明前者明显降低，ＣＤ４细胞，ＣＤ４／ＣＤ８比值非常显著性降低，ＣＤ８细胞呈显著升高，相关性分析表明：ｓＩＬ－２Ｒ水平与ＣＤ４细胞，ＣＤ４／ＣＤ８比值呈     

血液病患者外周血IL－2活性的观察

采用ＣｏｎＡ诱导的外周血淋巴细胞产生的白细胞介素Ⅲ（ＩＬ－２），用活化的Ｃ５７ＢＬ／ｂ小鼠脾细胞为反应细胞，以３Ｈ－ＴｄＲＤＮＡ掺入法测定５５例血液病患者ＩＬ－２活性，结果表明：①白血病及淋巴瘤、多发性骨髓瘤和由实体瘤引起的继发性贫血３３例其外周血ＩＬ－２活性与正常对照组相比明显降低（Ｐ＜０．００１）。②原发性血小板减少性紫癜（ＩＴＰ）７例其ＩＬ－２活性与对照组差异显著（Ｐ＜０．００１），其Ｔ细胞亚群ＯＫＴ４／Ｔ８＜Ｉ和Ｌ－２活性降低呈正相关，ＯＫＴ８百分值明显高于正常。     

老年心衰患者血清sIL—2R及T细胞亚群的变化

目的研究老年心衰（ＨＦ）患者血清中可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）及Ｔ淋巴细胞亚群（Ｔ－ＬＳ）的变化及临床意义。方法血清ｓＩＬ－２Ｒ测定采用酶联免疫吸附双抗体夹心法，Ｔ－ＬＳ采用抗体致敏的红细胞花环法。检测４０例老年ＨＦ及３０例正常组血清ｓＩＬ－２Ｒ及Ｔ－ＬＳ的变化。结果老年ＨＦ患者血清ｓＩＬ－２Ｒ水平与正常组比较显著增高（Ｐ＜０．０５，Ｐ＜０．０１）；Ｔ－ＬＳ在老年ＨＦ与正常组比较显著下降（Ｐ＜０．０５，Ｐ＜０．０１）。结论血清ｓＩＬ－２Ｒ水平及细胞免疫低下可影响老年ＨＦ的发病及预后     

健康老年人与高龄慢喘支急发患者淋巴细胞亚群变化观察

目的 了解正常老年人及高龄慢喘支急发患者细胞免疫的变化规律。探讨老年及高龄慢喘支急发对细胞免疫指标的影响及生理、病理意义。方法 应用流式细胞仪（FACSCALIBUR，美国BD公司）以“门技术”确定淋巴细胞亚群，分析比较28例健康青年、22例健康老年受试者及19例高龄慢喘支急发患者淋巴细胞亚群测定结果。结果 老年健康组的CD8较青年健康组有明显上升（P＜0．01），CD4／CD8有明显下降（P＜0．01）；高龄慢喘支急发组的CD4、CD4／CD8较老年健康组明显上升（P分别＜0．05和0．01），CD8有明显下降（P＜0．05）。结论：老年和高龄慢喘支急发患者的细胞免疫存在异常，加强免疫检测，对掌握病情和指导治疗有一定意义。     

Soluble interleukin 2 receptors in sera of Japanese patients with adult T cell leukemia mark activity of disease

Serum concentrations of soluble interleukin 2 receptors (sIL 2R) were measured by an enzyme-linked immunosorbent assay (ELISA) in 30 patients with adult T cell leukemia (ATL), in 9 patients with other hematopoietic malignancies, and in 17 asymptomatic individuals seropositive for human T cell leukemia virus type I (HTLV-I). Sixty HTLV-I seronegative, age-matched controls showed a normal range of form 63.2 to 480.8 U/mL. All asymptomatic carriers of HTLV-I had sIL 2R in their sera within the normal range. sIL 2R in sera was not related to the anti-HTLV-I antibody titer. Eleven patients with acute ATL, a clinical phenotype with median survival rate of 4.4 months, had markedly elevated sIL 2R (11,100 to 99,000 U/mL), but eight patients with smoldering ATL had low sIL 2R values (less than 480.8 U/mL) comparable to controls. Eleven patients with chronic ATL had intermediate elevated levels of sIL 2R (480.8 to 37,300.0 U/mL). Serum levels of sIL 2R correlated with the number of ATL cells (r = 0.812) and CD25-positive cells (r = 0.725) circulating in the peripheral blood. Longitudinal studies performed in four patients with ATL showed significant correlation between serum concentration of sIL 2R and activity of the malignancy. These findings suggest that the level of sIL 2R in serum indicated tumor load and, possibly, prognosis.     

肝硬化患者血清—氧化氮和几种白细胞介素检测的临床意义

目的　探讨肝硬化患者血清一氧化氮 (NO)、白细胞介素 2 (IL 2 )、白细胞介素 6 (IL 6 )、白细胞介素 8(IL 8)及可溶性白细胞介素 2受体 (sIL 2R)变化的临床意义。方法　应用ELISA法测定肝硬化患者及正常对照组的血清IL 6、IL 8及sIL 2R含量 ;应用MTT法检测血IL 2活性 ;应用荧光法检测血清NO水平。结果　肝硬化患者血清IL 2、sIL 2R、IL 6、IL 8及NO水平 :(5 741.5 3± 4376 .5 2 )U/ml、(486 .76± 46 .41)U/ml、(15 .78± 3.0 4) pg/ml、(2 3.89± 2 .13)pg/ml及 (6 .33± 0 .37) μmol/L ,显著高于正常对照组 :(173.88± 92 .2 1)U/ml、(2 42 .36± 35 .78)U/ml、(6 .14± 3.12 ) pg/ml、(17.71± 1.32 )pg/ml及 (3.6 8± 0 .34 ) μmol/L ,并随肝功受损程度进行性增加。 结论　肝硬化患者血清IL 2、sIL 2R、IL 6及IL 8增加可能为NO增多的诱发因素 ;肝功能损伤可能是白细胞介素活性增加的重要原因。     

Intrahepatic lymphocyte subpopulations and HLA class I antigen expression by hepatocytes in chronic hepatitis C.

The lymphocyte subpopulations in the peripheral blood and liver were studied in 17 patients with chronic active hepatitis type C (CAH C) by immunoenzymatic and immunofluorescence techniques, using mono-specific T cell antibodies and other reagents. The peripheral blood subsets showed no significant differences between the patients with CAH C and normal controls. In the liver, CD8-positive cells were predominant over CD4- and Leu 7-positive cells. Leu 7-, CD4-, and CD11-positive lymphocytes were all few in number. HLA class I antigen was expressed diffusely on the cell surfaces of the hepatocytes. Serum levels of soluble interleukin 2 receptor (sIL2R) in the CAH C patients were significantly higher than in normal controls (p less than 0.01). In CAH C, sIL2R levels were higher during exacerbations than during remissions (p less than 0.01). These results suggest that cytotoxic T cells (CD8- positive, CD4-negative, and CD11-negative) may play an important role in the pathogenesis of hepatocyte injury in patients with CAH C.     

Increased serum soluble interleukin 2 receptor levels in patients with viral liver diseases

Soluble interleukin 2 receptors (sIL 2R) in the sera of patients with viral liver diseases were quantified with a solid-phase enzyme immunoassay using two monoclonal antibodies against the receptors. The sIL 2R levels in patients with acute hepatitis, chronic hepatitis, liver cirrhosis and hepatocellular carcinoma were significantly higher than those in control subjects. In acute hepatitis patients, the high levels of sIL 2R observed during the florid stage returned to normal during remission. Levels in patients with chronic active hepatitis were significantly higher than in those with chronic persistent and lobular hepatitis, and levels observed during the exacerbation phase of chronic hepatitis were higher than they were during remission. Thus, in chronic hepatitis, sIL 2R levels increased in proportion to the inflammatory activity, and correlated well with serum transaminase (glutamic oxaloacetic transaminase: SGOT, glutamic pyruvic transaminase: SGPT) activities, but not with blood urea nitrogen or creatinine concentrations. In patients with a high degree of focal and piecemeal necrosis, serum sIL 2R levels increased further during recombinant interleukin 2 therapy. In post-hepatitic liver cirrhosis and hepatocellular carcinoma, sIL 2R levels correlated with serum cholinesterase and creatinine concentrations, but not with transaminase activities. Measurement of serum sIL 2R levels in patients with liver disease but without renal injury, may help in the diagnosis of inflammation in hepatitis, a process in which interleukin 2 may participate.     

病毒性肝炎和原发性肝癌患者血清IL2相关指标的意义

目的研究病毒性肝炎和原发性肝癌（ＨＣＣ）患者ＩＬ２，ｓＩＬ２Ｒ，ＩＬ６，Ｔ细胞亚群的变化意义．方法采用双抗体夹心ＥＬＩＳＡ法，ＡＢＳＥＬＩＳＡ法和红细胞花环实验对９４例各型病毒性肝炎和１０例ＨＣＣ进行了ＩＬ２，ＩＬ６，ｓＩＬ２Ｒ和Ｔ细胞亚群的测定，并与６６例健康献血员进行了对照．结果急性肝炎（ＡＨ）ＩＬ２水平增高，恢复期下降；而慢性肝炎（中重）、肝炎肝硬变（ＬＣ）、ＨＣＣ患者血清ＩＬ２水平明显低于慢性肝炎（轻）（Ｆ＝２０２６，Ｐ＜００１）和正常对照（ＮＣ）组．在乙型肝炎、ＨＢＶＤＮＡ阳性组的ＩＬ２水平显著低于ＨＢＶＤＮＡ阴性组．在ＣＨ，ＬＣ，ＨＣＣ组，ＩＬ２与ＣＤ＋４／ＣＤ＋８比值正相关，在各型肝炎和ＨＣＣＩＬ２与ｓＩＬ２Ｒ，ＩＬ６无相关关系．ＨＣＣ组的ＩＬ６水平高出正常１０倍以上，较各型肝炎组也明显升高（Ｆ＝３００７，Ｐ＜００１）．结论在病毒性肝炎和ＨＣＣ存在免疫功能紊乱和低下，淋巴因子网络失衡，这与肝炎和ＨＣＣ的病理生理机制有关，也为临床ＩＬ２治疗提供了理论依据．ＩＬ６的极显著增高有助于ＨＣＣ的诊断．     

Clinical significance of soluble interleukin-2 receptor as a putative systemic nutritional index in the elderly

The clinical significance of a slight increase of serum soluble interleukin-2 receptor (sIL2R) concentration in the stable elderly was investigated. Thirty-five residents of nursing homes with physical impairment as a sequel to cerebral infarctions, without any inflammatory condition, anodyne or immunological treatment, were divided into two groups: 24 without overt or suspected malignancy (NC) and 11 with a history of malignancy (CA). Serological screening with measurement of sIL2 R concentrations was performed and numbers of lymphocytes with CD4, CD8 markers were determined. The NC group was divided into controls (n = 15, sIL2R < = 883 U/mL) and subjects demonstrating elevation (n = 9, NH), as in a previous study. Differences were found in serum concentrations of albumin, blood urea nitrogen, total cholesterol concentration, Pettigrew's prognostic nutritional index (PNI), as well as the ADL score, but not age or sex between NH and controls. Factor analysis in NC revealed serum creatinine and blood urea nitrogen concentrations to correlate positively, and serum albumin, total cholesterol concentrations, ADL score, PNI to correlate negatively to sIL2R. Differences were found in sIL2R, albumin, total protein, total cholesterol, beta-lipoprotein, PNI between CA and controls, but correlations were not found in CA. Survival rate of controls over twenty-four months was better than that of NH, but not of CA. Our results suggest that a slight increase of concentration of sIL2R is related to subclinical systemic deterioration, especially with regard to nutrition, with a plausible connection to prognosis of the stable elderly without malignancy.     

Increased levels of serum soluble interleukin 2 receptor (sIL2R) in patients with chronic liver diseases

sIL2R in the sera of patients with viral liver diseases and primary biliary cirrhosis (PBC) were quantified with a solidphase enzyme immunoassay using two monoclonal antibodies against the receptor. As IL2 upregulated sIL2R release in vitro and in vivo, the serum levels of sIL2R might be a useful marker for T cell mediated immune responses. The sIL2R in patients with acute hepatitis, chronic hepatitis (CH) and PBC were significantly higher than those in control subjects. Serum sIL2R in patients with CH and PBC was capable of binding IL2 and did not affect IL2 depended immune responses of blastoid lymphocytes. These results suggest that IL2 production and sIL2R release increase significantly in patients with CH and PBC, and IL2 depended cytotoxic T cells may play a role of pathogenesis of CH and PBC.