巨细胞病毒肝炎患儿血浆白细胞介素-12 p40水平测定及意义

目的探讨巨细胞病毒(CMV)肝炎患儿血浆白细胞介素(IL)-12亚基p40的水平及意义。方法采用双抗体夹心酶联免疫吸附试验(ELISA)测定52例CMV肝炎患儿更昔洛韦抗病毒治疗前后及36例健康儿童血浆IL-12p40水平,采用速率法和实时荧光定量聚合酶链反应(FQ-PCR)分别测定CMV肝炎患儿血浆ALT活性和尿液HCMV DNA载量。结果 CMV肝炎组血浆IL-12p40水平(pg/ml)(M=536.5,P5=123.5,P95=1061.1)低于正常对照组(M=632.2,P5=226.7,P95=1829.3),经检验差异有统计学意义(Z=-2.721,P0.01)。CMV肝炎患儿血浆IL-12p40水平与其ALT活性(U/I)、尿液HCMV DNA载量(拷贝/ml,lg)呈显著负相关(r=-0.433、-0.491,均P0.01)。治疗有效组血浆IL-12p40水平与入院时比较差异有统计学意义(Z=-5.004,P0.01),而无效组患儿治疗前后血浆IL-12p40水平差异无统计学意义(Z=-1.449,P0.05)。结论 CMV肝炎患儿存在血浆IL-12p40水平低下,其水平变化在一定程度上可反应患儿体内CMV病毒载量及肝脏损害程度,并对预测更昔洛韦抗病毒疗效有一定价值。

Detection of plasma IL-12 p40 level in infants with cytomegalovirus hepatitis and its significance

Objective To understand the changes of IL-12 p40 level in plasma in infants with cytomegalovirus （CMV） hepatitis and its significance. Methods The level of IL-12 p40 was detected by using double antibody ELISA for the healthy infants as control （n=36） and the infants with CMV hepatitis （n=52） before and after treatment of ganciclovir. ALT activity in plasma and HCMV DNA in urinary of cytomegalovirus hepatitis infants were also detected. Results The IL-12 p40 level of the infants with CMV hepatitis （M=536.5,P5=123.5,P95=1061.1） was lower than that of the healthy infants （M=632.2,P5=226.7,P95=1829.3）,and significant difference existed between two groups （Z=-2.721,P〈0.01）. The level of IL-12 p40 of the infants with CMV hepatitis was negatively correlated with ALT activity（U/I）in plasma and HCMV DNA（copies/ml,lg）in urinary （r=-0.433、-0.491,P〈0.01）. Among the infants with CMV hepatitis who were sensitive to the treatment,the level of IL-12 p40 increased after treatment significantly （Z=-5.004,P〈0.01）,but there was no significant increase among the infants with CMV hepatitis who were resistant to the treatment （Z=-1.449,P〉0.05）. Conclusion The level of IL-12 p40 of the infants with CMV hepatitis was lower than that of the healthy infants,the change might reflect the load of HCMV DNA and the severity of liver damage for infants with CMV hepatitis,and could be used to predict the effect of ganciclovir intervention.