特发性血小板减少性紫癜患儿血清IL-6,sIL-2R的变化及意义

目的 探讨特发性血小板减少性紫癜(ITP)患儿血清中细胞因子白介素6(IL-6)、可溶性白介素2受体(sIL-2R)的变化及临床意义.方法 采用双抗体夹心酶联免疫(ELISA)定量测定方法检测37例ITP患儿和20例正常健康儿童血清中IL-6、sIL-2R水平,同时对其中25例ITP患儿进行血小板相关抗体PAIb(IgG、IgA、IgM)的定性测定,并对ITP患儿外周血中血小板计数、血清IL-6、sIL-2R水平进行相关分析.结论 ITP患儿血清IL-6、sIL-2R水平均显著高于正常对照组(P<0.01),ITP患儿治疗前血清IL-6、sIL-2R水平均显著高于治疗后(P<0.01);ITP患儿重度出血组血清IL-6、sIL-2R水平均明显高于轻度出血组(P<0.05);25例ITP患儿测定血小板相关抗体(PAIgA、PAIgG、PAIgM),全阳性9例,阳性率36%(9/25),ITP患儿血小板相关抗体全阳性组血清IL-6、sIL-2R水平均明显高于非全阳性组(P<0.05);ITP患儿治疗前血清IL-6、sIL-2R水平与血小板数均呈负相关(r=-0.802,P<0.01;r=-0.700,P<0.01),IL-6与sIL-2R水平之间呈正相关(r=0.592,P<0.01).结论IL-6、sIL-2R参与了ITP的发病过程,其水平高低随病情轻重、病程而变化,进一步说明除体液免疫以外,细胞免疫也参与了ITP的发病过程.

Changes of serum IL-6 and sIL-2R levels in patients with idiopathic thrombocytopenic purpura and their clinical significance

Objective To study the changes and the clinical significance of serum IL-6 and sIL-2R levels in children with idiopathic thrombocytopenic purpura( ITP). Methods The levels of serum IL-6 and sIL-2R were measured in 37 ITP children with sandwich ELSIA as well as in 20 healthy children. At the same time, PAIb' s qualitative determination was checked in 25 ITP children. And the relationships of PLT counts,IL-6 and sIL-2R's level in ITP children' s peripheral blood were analyzed. Results The levels of ITP children' s IL-6 and sIL-2R were significantly higher than those of control group(P <0. 01). The levels of IL-6 and sIL-2R were dramatically higher in the group of ITP children before treatment responsive to after treatment(P <0.01 ). The levels of severe hemorrhage group' s IL-6, sIL-2R were significantly higher than those of hyporrhea group' s( P < 0.05 ). Nine of 25 ITP children' s PAIb was completely positive(9/25) ,the levels of ITP children's IL-6, sIL-2R in completely positive group were significantly higher than non-positive group' s( P < 0. 05 ). The levels of ITP children' s IL-6, sIL-2R ( before treating) were negative correlation with PLT counts. The level between ITP children' s IL-6 and sIL- 2R was positive correlation. Conclusion PIL-6 and sIL-2R participate in ITP' s procedure. The levels change with the pathogenetic condition and the course of disease. To sum up, cell mediated immunity plays a role in ITP' s procedure as well as humoral-mediated immunity.