摘要目的 分析噬血细胞综合征(HLH)患儿的细胞因子情况.方法 化学发光法检测本科HLH患儿的细胞因子水平.结果 41例HLH患儿在HLH急性期各细胞因子水平的中位值如下:IL-1 β为5.00(5.00～38.70) pg/ml、IL-2R为13 890.00 (2 311.00～57 420.00) U/ml,IL-6为14.80(2.00～1 000.00) pg/ml、IL-8为42.20(5.00～3 907.00) pg/ml、IL-10为125.00(5.00～1 000.00)pg/ml、TNF α为34.50(5.69~265.00) pg/ml,缓解后各细胞因子水平明显下降.其中IL-2R、IL-10、TNFα水平均明显高于对照组,差异均有统计学意义(均P＜0.001).根据ROC曲线设定HLH的细胞因子诊断标准如下:IL-2R＞2 277.50 U/ml且IL-10＞10.40 pg/ml,特异性0.889,敏感性0.791.结论 HLH病因复杂,临床表现多样,病情进展迅速,及早检测细胞因子指标及时确诊对预后至关重要.

abstractsObjective To analyze the cytokin in children with hemophagocytic lymphohistiocytosis (HLH).Method The cytokine levels in children with HLH at the Department of Pediatrics,Sun Yat-sen Memorial Hospital were detected by chemiluminescence method.Results The median values of cytokine levels in the 41 children with HLH in the acute phase were as below:IL-1β 5.00 (5.00-38.70) pg/ml,IL-2R 13 890.00 (2 311.00-57 420.00) U/ml,IL-6 14.80 (2.00-1 000.00) pg/ml,IL-8 42.20 (5.00-3 907.00) pg/ml,IL-10 125.00 (5.00-1000.00) pg/ml,and TNFα 34.50 (5.69-265.00) pg/ml.After remission,the level of each cell factor decreased significantly.The levels of IL-2R,IL-10,and TNFα were significantly higher than those in the control group.According to the ROC curve,the cytokine diagnostic criteria of HLH were IL-2R ＞ 2 277.50 U/ml and IL-10 ＞ 10.40 pg/ml.Conclusions The etiology of HLH is complex.HLH has various clinical manifestations and rapid progress.Early detection of cytokine and timely diagnosis and intervention are crucial for the prognosis.