2009甲型H1N1流感患者的细胞因子研究

目的：观察细胞因子在甲型H1N1流感患者中的变化趋势。方法：观察2009年12月至2010年2月入住昆明医学院第一附属医院ICU科的20例确诊的甲型H1N1流感患者,均治愈出院。以氧合指数200为界限进行分组,分为氧合指数≥200组（A组）和氧合指数〈200组（B组）,监测两组细胞因子的变化趋势。结果：①相对于A组,入院时及治疗第1天,B组的白介素-2（IL-2）明显增高（P〈0.05）。②与A组相比,治疗第3天,B组白介素-4（IL-4）明显增高（P〈0.01）。③白介素-6（IL-6）总体均数明显呈下降趋势,由（27.26±27.88）pg/mL下降至（1.15±0.51）pg/mL。与A组相比,入院时及治疗第1天,B组IL-6明显增高（P〈0.01）。④与A组相比,入院时及治疗第3天B组,白介素-10（IL-10）明显增高（P〈0.05）。⑤肿瘤坏死因子-α（TNF-α）总体均数明显呈下降趋势,由（37.56±48.48）pg/mL下降至（6.25±9.29）pg/mL。与A组相比,B组TNF-α明显增高（P〈0.01）。结论：①甲型H1N1流感重症患者（氧合指数〈200）的细胞因子IL-2、IL-6、IL-10和TNF-α比氧合指数≥200组的高。②随着病情的好转,致炎因子IL-2、IL-6和TNF-α逐渐下降,而抑炎因子IL-4和IL-10先升高,后下降。

Research on cytokines in patients infected with 2009 H1N1 influenza virus

Objective: To observe the changes of cytokines in patients infected with 2009 H1N1 influenza virus.Methords: A total of 20 patients infected with 2009 H1N1 influenza virus in ICU of the 1st Affiliated Hospital of Kunming Medical College were diagnosed and discharged.All of 20 patients was divided into Group A(oxygenation index≥200) or Group B(oxygenation index < 200) with oxygenation index 200.The change of cytokines of two groups was observed.Results: ①Compared to Group A,Interleukin-2(IL-2) of Group B significantly in-creased on admission day and the 1st day of therapy(P<0.05).②Compared to Group A,Interleukin-4(IL-4) of Group B significantly increased on the 3rd day of therapy(P<0.01).③Means of Interleukin-6(IL-6) decreased from(27.26±27.88) pg/mL to(1.15±0.51) pg/mL.Compared to Group A,IL-6 of Group B significantly increased on admission day and the 3rd day of therapy(P<0.01).④Compared to Group A,Interleukin-10(IL-10) of Group B significantly increased on admission day and the 3rd day of therapy(P<0.05).⑤Means of Tumor Necrosis Factor-α(TNF-α) decreased from(37.56±48.48) pg/mL to(6.25±9.29) pg/mL.Compared to Group A,TNF-α of Group B signifi-cantly increased(P<0.01).Conclusion: ①The level of cytokines of severe patients infected with H1N1 influ-enza virus(oxygenation index < 200),IL-2,IL-6,IL-10 and TNF-α,are higher than oxygenation index≥200.②With the improvement of state of illness,the levels of IL-2,IL-6 and TNF-α,slowly decrease,but the levels of IL-4 and IL-10 increase,then decrease.