CAJ | 학술논문

目的探讨外周血单个核细胞核因子( nuclear factor,NF)-κB活化状态及血清炎症细胞因子在婴儿捂热综合征(infant muggy syndrome,IMS)中的临床意义.方法 2008年1月至2011年1月采用酶联免疫吸附法检测100例IMS患儿及32例健康儿童(对照组)外周血单个核细胞NF-κB活化率及白细胞介素( interleukin,IL)-17、IL-6、肿瘤坏死因子(tumor necrosis factor,TNF)-α和IL-10血清水平.同时采用流式细胞法检测其中46例IMS患儿及32例对照组儿童NF-κB阳性率,并分析以上指标与多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)的关系.结果与对照组相比,100例IMS患儿采用酶联免疫吸附法检测的NF-κB活化率[(11.042±6.792)％vs (4.528±1.378)％]及46例IMS患儿采用流式细胞法检测的NF-κB阳性率[(28.780±13.820)％ vs(7.078±5.395)％]均明显升高(P均＜0.01).IMS患儿血清IL-17、IL-6、IL-10水平均显著高于对照组(P均＜0.01),血清TNF-α水平稍高于对照组,但差异无统计学意义(P＞0.05).IMS合并MODS患儿NF-κB活化率[(14.591±7.626)％vs(8.576±4.851)％]、NF-κB阳性率[(36.087±12.056)％vs( 23.590±11.263)％]及IL-17、IL-6、TNF-α和IL-10水平均显著高于不合并MODS者(P＜0.01).结论外周血单个核细胞NF-κB活化及血清IL-17、IL-6水平对IMS患儿的缺氧性炎症损伤起重要作用.NF-κB高度活化及IL-17、IL-6、TNF-α高度活化与IMS患儿发生MODS有关.血清IL-10水平增高未能阻止IMS患儿的缺氧性炎症损伤.
목적 탐토외주혈단개핵세포핵인자( nuclear factor,NF)-κB활화상태급혈청염증세포인자재영인오열종합정(infant muggy syndrome,IMS)중적림상의의.방법 2008년1월지2011년1월채용매련면역흡부법검측100례IMS환인급32례건강인동(대조조)외주혈단개핵세포NF-κB활화솔급백세포개소( interleukin,IL)-17、IL-6、종류배사인자(tumor necrosis factor,TNF)-α화IL-10혈청수평.동시채용류식세포법검측기중46례IMS환인급32례대조조인동NF-κB양성솔,병분석이상지표여다기관공능장애종합정(multiple organ dysfunction syndrome,MODS)적관계.결과 여대조조상비,100례IMS환인채용매련면역흡부법검측적NF-κB활화솔[(11.042±6.792)％vs (4.528±1.378)％]급46례IMS환인채용류식세포법검측적NF-κB양성솔[(28.780±13.820)％ vs(7.078±5.395)％]균명현승고(P균＜0.01).IMS환인혈청IL-17、IL-6、IL-10수평균현저고우대조조(P균＜0.01),혈청TNF-α수평초고우대조조,단차이무통계학의의(P＞0.05).IMS합병MODS환인NF-κB활화솔[(14.591±7.626)％vs(8.576±4.851)％]、NF-κB양성솔[(36.087±12.056)％vs( 23.590±11.263)％]급IL-17、IL-6、TNF-α화IL-10수평균현저고우불합병MODS자(P＜0.01).결론 외주혈단개핵세포NF-κB활화급혈청IL-17、IL-6수평대IMS환인적결양성염증손상기중요작용.NF-κB고도활화급IL-17、IL-6、TNF-α고도활화여IMS환인발생MODS유관.혈청IL-10수평증고미능조지IMS환인적결양성염증손상.
Objective To investigate the clinical significance of nuclear factor ( NF)-κB activation in peripheral blood mononuclear cells (PBMCs) and the serum levels of correlated inflammatory cytokines in children with infant muggy syndrome(IMS).Methods Blood samples from 100 patients with IMS and those from 32 healthy infants( control group)were detected by ELISA for amount of NF-κB activation in PBMCs and for serum levels of interleukin ( IL ) -17,IL-6,tumor necrosis factor ( TNF ) -α and IL- 10 respectively from Jan 2008 to Jan 2011.At the same time,blood samples from 46 out of the above 100 patients with IMS and those from the 32 controls for positive rate of activation of NF-κB in PBMCs were detected by flow cytometry as well.The relationship between all the data and multiple organ dysfunction syndrome( MODS ) were analyzed respectively.Results As compared with that of control group,the percentage of activated NF-κB in PBMCs in 100 patients with IMS detected by ELISA [ ( 11.042 ± 6.792 ) ％ vs ( 4.528 ± 1.378 ) ％ ] and the positive rate of NF-κB activation in 46 patients with IMS detected by flow cytometry [ ( 28.780 ± 13.820 ) ％ vs (7.078 ±5.395)％ ] were both significantly higher ( P ＜0.01 ).The serum levels of IL-17,IL-6 and IL-10were also significantly higher in patients with IMS than those in control group( P ＜0.01 ).The serum level of TNF-α was higher in patients with IMS than that in control group but without significance( P ＞ 0.05 ).The percentage of activated NF-κB [ ( 14.591 ± 7.626) ％ vs ( 8.576 ± 4.851 ) ％ ],the positive rate of NF-κB activation [ ( 36.087 ± 12.056) ％ vs ( 23.590 ± 11.263 ) ％ ],and the serum levels of IL- 17,IL-6,TNF-α and IL-10 were all significantly higher in IMS patients with MODS than those in IMS patients without MODS ( P ＜ 0.01 ).Conclusion The inflammatory factors of NF-κB activation in PBMCs and the high serum levels of IL-17 and IL-6 are potent to cause inflammatory damage in IMS patients,and the serum level of IL-10 is not able to compensate the damage.The activation of NF-κB and high serum levels of IL-17,IL-6 and TNF-α are correlated with MODS.