新生儿HIE血清IL-6、IL-8与TNF-α动态变化及临床意义探讨

为探讨新生儿缺氧缺血性脑病(HIE)外周血IL-6、IL-8与TNF-α变化的临床意义,采用放射免疫法,对生后1天(24小时内)、3天及7天检测了40例HIE患儿及40例正常新生儿外因血IL-6、IL-8与TNF-α水平.结果显示,与正常新生儿比较,HIE患儿生后1天血清IL-6水平分别为(52.6±24.5)对(80.2±29.4)ng/L(P＜0.01),IL-8分别为(0.47±0.13)对(0.68±0.16)μg/L(P＜0.01),TNF-α分别为(1.18±0.31)对(0.91±0.30)μg/L(P＜0.01),而且病情越重改变越明显;至生后1周IL-6、TNF-α恢复至正常,与对照组水平相比P＞0.05,而IL-8则仍显著低于正常新生儿(P＜0.01).因此,认为围产期窒息与HIE患儿外周血IL-6与IL-8水平减低,TNF-α水平升高;它们可能参与了新生儿缺氧缺血性脑损伤的某些发病过程.     

舌下特异性免疫治疗过敏性鼻炎/过敏性哮喘患儿IL-17和IL-35水平的变化及临床疗效

目的 探讨舌下特异性免疫治疗(SLIT)的机制,并评价SLIT的临床疗效.方法 随机选取2011年1~12月行SLIT治疗的粉尘螨过敏性鼻炎(AR)和/或过敏性哮喘(AS)患儿30例为病例组,另随机选取行体检的30例健康儿童为对照组.检测病例组行SLIT治疗前及治疗1、2年时的1秒钟用力呼气容积(FEV1)或气道阻力与预计值之比、嗜酸性粒细胞(Eos)计数及血清细胞因子IL-17和IL-35水平,与对照组进行比较分析;同时对病例组患儿的鼻炎/哮喘症状进行评分并监测哮喘控制水平.结果 病例组SLIT治疗前、治疗1年时IL-17水平均明显高于对照组(P<0.01);且IL-17水平在治疗前、治疗后1年及治疗后2年呈逐年下降趋势(P<0.01),至治疗2年时与对照组比较差异无统计学意义(P>0.05).血清IL-35水平在治疗前后的变化趋势与IL-17的变化趋势刚好相反.FEV1与预计值之比在治疗前、治疗后1年及治疗后2年呈逐年上升趋势(P<0.01);而气道阻力与预计值之比、Eos计数则呈逐年下降趋势(P<0.01).病例组SLIT治疗2年时的鼻炎症状总评分和哮喘症状总评分改善百分率均较治疗1年时明显增高(P<0.01);SLIT治疗AR 1年时显效率85%,2年时达100%;SLIT治疗AS 1年时控制率为76%,2年时控制率达92%.结论 SLIT是一种有效治疗儿童AR和AS的方法,可能是通过抑制IL-17并促进IL-35的表达水平从而达到治疗目的,且治疗2年的效果较1年更好.     

支原体肺炎患儿肺泡灌洗液中TNF-α、IL-6、IL-10水平检测及意义

目的：探讨肺炎支原体肺炎（MPP）患儿支气管肺泡灌洗液（BALF）中细胞因子TNF-α、IL-6、IL-10的水平及其临床意义。方法：采用双抗体夹心ELISA法对45例MPP急性期患儿、30例MPP恢复期患儿和20例无肺部病变的对照组患儿BALF中TNF-α、IL-6、IL-10的水平进行测定。结果：MPP患儿急性期BALF中TNF-α、IL-6、IL-10水平高于对照组,差异有统计学意义（P＜0.05）;恢复期TNF-α、IL-6水平较急性期明显下降,与对照组相比无统计学意义（P＞0.05）,恢复期IL-10水平仍持续升高,与急性期相比其水平无明显改变（P＞0.05）。结论：急性期MPP患儿BALF中TNF-α、IL-6、IL-10等细胞因子水平增高,这些细胞因子可能参与了MPP的发病。     

感染性危重患儿血浆 IL-1、IL-6、IL-8、TNF-α变化及临床意义

感染性疾病仍是目前儿童死亡的主要病因。感染性危重患儿是根据小儿危重病例评分法[1]确诊为危重患儿 ,再根据病原学检查确诊为细菌、病毒、真菌等感染的患儿 ,约占PICU住院患儿的88.16 %。在感染性危重患儿早期病原未明的情况下 ,治疗针对性不强 ,并带有一定的盲目性 ,致使有些患儿疗效欠佳 ,如何找到一个早期的生化指标来指导临床治疗 ,避免在病原未明确前临床治疗的盲目性 ,提高抢救成功率 ,显得非常重要。对象与方法一、对象1999年1月至2000年12月入住本院PICU的危重患儿152例 ,其中男103例 ,女49例。年龄最小30天 ,最大12岁。根据…     

新生儿HIE脐血IL-6、IL-8与TNF-α变化及临床意义探讨

为探讨新生儿缺氧缺血性脑病 ( HIE)脐血 IL - 6、IL - 8与 TNF-α的变化及临床意义 ,应用放射免疫法检测了 4 0例 HIE患儿 IL- 6、IL- 8与 TNF- α水平 ,并与 4 0例正常新生儿比较。结果显示与正常新生儿比较 ,HIE患儿与正常对照儿相比脐血IL - 6水平分别为 ( 61.0 4± 2 3 .0 6)对 ( 91.83± 3 7.5 4 ) ng/L ( P<0 .0 1) ,IL - 8分别为( 0 .3 4± 0 .0 9)对 ( 0 .2 6± 0 .0 7) μg/L( P<0 .0 1) ,TNF- α分别为 ( 1.0 3± 0 .3 0 )对 ( 0 .83± 0 .3 1) μg/L( P<0 .0 1) ;而且病情越重改变越明显。因此 ,我们认为 ,围产期窒息与HIE患儿脐血 IL - 6水平减低、IL - 8与 TNF-α水平升高有关 ;它们可能参与了新生儿缺氧缺血性脑损伤的某些发病过程     

哮喘患儿血IL-16 IL-18免疫球蛋白的动态变化及相关分析

目的：探讨哮喘患儿IL-16,IL-18,免疫球蛋白的动态变化及IL-１６,IL-18与免疫球蛋白之间的关系,为哮喘的发病机制及抗变态反应性炎症治疗提供理论依据。方法：对34例哮喘儿童及21例健康体检儿童（对照组）运用双抗夹心酶联免疫吸附试验（ELISA）法测定IL-16,IL-18,IgE,运用免疫比浊法测定IgG,IgM,IgA。结果：哮喘发作期、缓解期IL-18与对照组比较差异有显著性（P<0.01）;发作期IL-16,IgE,IgG均显著高于对照组（P<0.01或P<0.05）,IgA显著低于对照组（P<0.01）;缓解期IL-16,IgE均显著高于对照组（P<0.01）。发作期及缓解期IL-16,IL-18呈正相关（r=0.70, P<0.01;r=0.70,P<0.05）,发作期IL-16与IgE呈正相关（r=0.624,P<0.01）。结论： 哮喘患儿发作期与缓解期均存在免疫失衡状态,IL-16,IL-18及IgE与哮喘发病机制有关,哮喘患儿在缓解期也应继续抗变态反应性炎症治疗,针对这些细胞因子的治疗具有潜在的价值。［中国当代儿科杂志,2006, 8 (1):6-8］     

病毒感染危重患儿血浆IL-1、IL-8、TNF-α的变化及临床意义

病毒感染危重患儿是根据小儿危重病例评分法确诊为危重患儿，再根据病原学检查确诊为病毒感染的患儿，约占PICu住院患儿的17．76％，在病毒感染危重患儿早期病原未明的情况下，治疗针对性不强并带有一定的盲目性。如何找到一个早期的生化指标来指导临床治疗，弥补在病原未明确前临床治疗的盲目性，提高抢救成功率，显得非常重要。     

哮喘患儿血清IL-8、IL-10及TNF-α检测的临床意义

目的 探讨白细胞介素(IL-8、IL-10)和肿瘤坏死因子(TNF—α)在支气管哮喘发病机制中的作用。方法 采用酶联免疫吸附试验检测哮喘急性发作期、缓解期各40例患儿和健康儿童的IL-8、IL-10、TNF-α水平。结果 哮喘急性发作期患儿血清IL-8、TNF—α水平明显高于缓解期及健康对照组，IL-10水平明显低于缓解期及健康对照组，差异均有显著性；哮喘急性发作期患儿治疗后血清IL-8、TNF—α水平明显低于治疗前，而IL-10有明显上升，差异均有显著性。结论 哮喘的气道炎症可能与IL-8、TNF-α的上调和IL-10的消耗性降低有关，表明IL-8、IL-10、TNF-α参与了哮喘的气道炎症反应。     

败血症危重患儿与血浆IL-6 TNF-α关系的探讨

目的　败血症危重患儿在病原未明确前临床治疗有一定的盲目性 ,该文探讨败血症危重患儿与血浆IL 6 ,TNF α水平的关系 ,找到一个生化指标来协助败血症危重患儿病原菌未明确前的临床诊断 ,提高抢救成功率。方法　采用酶联免疫法检测 31例败血症危重患儿及 2 3例病毒感染危重患儿 ,2 0例健康体检儿童血浆IL 6 ,TNF α的水平。结果　败血症危重患儿组血浆IL 6 ,TNF α水平高于病毒感染危重患儿组和正常健康组 ,差异均有显著性意义 (P <0 .0 1) ,病毒感染危重患儿组血浆IL 6 ,TNF α水平高于正常健康组 ,差异有显著性意义 (P <0 .0 1)。结论　血浆IL 6 ,TNF α水平升高提示感染存在 ,当血浆IL 6 ,TNF α水平升高明显时对败血症危重患儿的诊断有一定的临床参考价值。     

儿童急性白血病血清IL-6、IL-8水平测定的意义

为探讨血清IL-6、IL-8水平变化与儿童急性白血病(AL)发生、发展及预后的关系。采用夹心酶联免疫吸附法检测68例儿童AL患者血清IL-6、IL-8水平。结果，儿童AL患者血清IL-6、IL-8水平愈高；发生出血愈严重，血清IL-6水平愈高，但血清IL-8水平在轻、中度出血时显著升高，而发生严重出血倾向时并不升高；当儿童AL治疗获缓解时，血清脯、IL-8水平逐渐下降，完全缓解时，接近于正常水平。结果表明：血清IL-6、IL-8的异常表达在儿童AL的发生、发展中可能起着一定作用，检测儿童AL血清IL-6、IL-8水平可能作为判断疗效、估计预后及监测复发的指标之一。     

C-reactive protein, Il-6 and procalcitonin as infection parameters in children with oncologic diseases

BACKGROUND: Due to anti-neoplastic therapy, there is a high incidence of infections and fever in pediatric patients with malignant disease. We have searched for parameters that may be of value in the early diagnosis of infection, in discriminating between bacterial and non-bacterial causes and for monitoring the response to antimicrobiotic therapy. PATIENTS: 46 febrile episodes in 33 children with malignant diseases under anti-neoplastic therapy, aged 0.5 to 17 years, were included. Each patient was supplied with a central venous catheter (Hickman catheter). METHODS: Blood was taken for the evaluation of C-reactive-protein (CRP), Interleukin-6 (IL-6) and Procalcitonin (PCT). Laboratory data included WBC, blood cultures, as well as microbiologic and serologic tests for important infectious agents. Patients were grouped as follows: 1. Patients with febrile diseases and positive blood cultures, 2. Patients with localized bacterial or mycotic infections and negative blood cultures, 3. Patients with fever of unknown origin, 4. Patients with viral infections, 5. Control group. RESULTS: CRP and IL-6 were more sensitive than PCT in detecting bacterial and mycotic diseases in leukopenic children, because of low PCT-levels in patients with localized infections. IL-6 values were high shortly after onset of fever and decreased under sufficient antimicrobiotic therapy until day three. CONCLUSIONS: Because of the quick response, IL-6 may be helpful in monitoring antimicrobiotic therapy. Using Procalcitonin-levels, we were not able to distinguish between localized bacterial and viral infection in leukocytopenic patients.     

Pubertal growth and development and prenatal and lactational exposure to polychlorinated biphenyls and dichlorodiphenyl dichloroethene

OBJECTIVES: Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) are ubiquitous toxic environmental contaminants. Prenatal and early life exposures affect pubertal events in experimental animals. We studied whether prenatal or lactational exposures to background levels of PCBs or DDE were associated with altered pubertal growth and development in humans.Study design: Follow-up of 594 children from an existing North Carolina cohort whose prenatal and lactational exposures had previously been measured. Height, weight, and stage of pubertal development were assessed through annual mail questionnaires. RESULTS: Height of boys at puberty increased with transplacental exposure to DDE, as did weight adjusted for height; adjusted means for those with the highest exposures (maternal concentration 4+ ppm fat) were 6.3 cm taller and 6.9 kg larger than those with the lowest (0 to 1 ppm). There was no effect on the ages at which pubertal stages were attained. Lactational exposures to DDE had no apparent effects; neither did transplacental or lactational exposure to PCBs. Girls with the highest transplacental PCB exposures were heavier for their heights than other girls by 5.4 kg, but differences were significant only if the analysis was restricted to white girls. CONCLUSIONS: Prenatal exposures at background levels may affect body size at puberty.     

Hypokalemia and Hyperkalemia in Infants and Children: Pathophysiology and Treatment

Potassium is the second most abundant cation in the body. About 98% of potassium is intracellular and that is particularly in the skeletal muscle. Electrical disturbances associated with disorders of potassium homeostasis are a function of both the extracellular and intracellular potassium concentrations. Clinical disorders of potassium homeostasis occur with some regularity, especially in hospitalized patients receiving many medications. This article will review the pathophysiology of potassium homeostasis, symptoms, causes, and treatment of hypo- and hyperkalemia.