下呼吸道感染患者血清与肺泡灌洗液白细胞介素-8、白细胞介素-6的动态监测

目的　探讨血清和肺泡灌洗液 (BALF)中白细胞介素 - 8(IL - 8)、白细胞介素 - 6 (IL - 6 )与下呼吸道感染的相关性 ,IL - 8和IL - 6在炎症反应中的作用。方法　采用ELISA法分别测定 36例下呼吸道感染患者 (感染组 )治疗前后、2 8例哮喘发作期患者 (哮喘组 )及 12例正常人 (对照组 )的血清和BALF的IL - 8、IL - 6水平 ,计算BALF的中性粒细胞 (PMN)和肺泡巨噬细胞 (AMs)数量。结果　感染组治疗前血清IL - 8和IL - 6水平比治疗后、哮喘组及对照组显著增高 (P <0 0 1)。哮喘组血清IL - 8和IL - 6水平比感染组治疗后明显增高 (P <0 .0 1)。BALF的细胞总数、PMN、IL - 8及IL - 6水平感染组治疗前显著比治疗后、哮喘组及对照组高 (P <0 0 1) ,哮喘组高于感染组治疗后及对照组 (P <0 0 1)。革兰阴性细菌感染患者BALF的IL - 8及IL - 6水平比革兰阳性细菌感染患者显著增高 (P <0 0 1)。感染组BALF的IL - 8水平分别与PMN和AMs呈显著正相关 (r =0 90 5 6 ,r =0 6 2 6 9,P <0 0 1)。感染组BALF的IL - 6水平与AMs呈显著正相关 (r =0 70 5 2 ,P <0 0 1)。结论　IL - 8和IL- 6参与下呼吸道感染的炎症反应 ,血清和BALF中IL - 8和IL - 6的动态变化对评价下呼吸道感染的病情和转归有一定的临床意义。

Dynamic changes of BALF and serum IL-8 and IL-6 levels in patients with lower respiratory tract infection

Objective To investigate the relationship between interleukin-8 (IL-8),interleukin-6 (IL-6) and pathogenesis of lower respiratory infection(RI).Methods Bronchoalveolar lavage fluid (BALF) and serum IL-8,IL-6 levels were detected by enzyme linked immunosorbent assay (ELISA) in 36 patients with lower RI,28 patients with unstable asthma and 12 controls. Neutrophils (PMN) and alveolar macrophages (AMs) of BALF were examined.Results The levels of serum IL-8 and IL-6 of RI before treatment were significantly higher than those of RI after treatment,of unstable asthma,and of controls (P<0.01).The levels of serum IL-8,IL-6 of unstable asthma were significantly higher than those of RI after treatment (P<0.01).BALF total cell count,PMN,levels of IL-8 and IL-6 of RI before treatment were significantly higher than those of RI after treatment,of unstable asthma and of controls (P<0.01).Compared with RI after treatment and controls,there was significant increase in the BALF total cell count,PMN,levels of IL-8 and IL-6 in unstable asthma (P<0.01).BALF levels of IL-8 and IL-6 were significantly higher in Gram-negative RI than in Gram-positive RI (P<0.01).BALF level of IL-8 was correlated positively with PMN and AMs respectively in RI (r=0.9056,0.6269).BALF level of IL-6 showed positive correlation with AMs in RI (r=0.7052,P<0.01).Conclusion IL-8 and IL-6 play a role in the development of airway inflammation in RI.Detection of BALF and serum levels of IL-8 and IL-6 is of value to predicte the state and prognosis of RI.