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目的 探讨细胞因子干扰素γ(IFNγ)、干扰素诱导蛋白10(IP-10)及受体CXCR3在感染相关性噬血细胞综合征(infection-associated hemophagocytic syndrome,IAHPS)患者中的表达及临床意义.方法 采用酶联免疫吸附试验(ELISA)检测43例IAHPS患者血清IFNγ和IP-10的表达,以流式细胞术检测外周血CD_4~+和CD_8~+T淋巴细胞表面CXCR3的表达,并以无HPS感染组(35例)和健康体检者(20名)作为对照.采用SPSS 13.0软件分析数据,组间比较采用独立样本t检验.结果 IAHPS组血清IFNγ和IP-10水平分别为(608±135)pmol/L和(939±141)pmol/L,明显高于无HPS感染组[(154±45)pmol/L、(385±119)pmol/L,t值分别为4.97和4.02,P值均<0.05]和健康对照组[(56±18)pmol/L、(248±98)pmol/L,t值分别为5.27和4.77,P值均<0.05].IAHPS组的CD4+和CD8+T淋巴细胞表面CXCR3的表达分别为(35±11)%和(23±8)%,明显高于无HPS感染组[(24±7)%、(16±7)%,t值分别为3.12和3.62,P值均<0.05]和健康对照组[(20±6)%、(12±5)%,t值分别为4.46和4.93,P值均<0.05].结论 IAHPS患者外周血IFNγ和IP-10表达明显升高,CD_4~+和CD_8~+T淋巴细胞上的受体CXCR3表达也增强,这些趋化因子的异常表达可能与HPS的发病机制相关.

Objective To investigate the expressions of interferon γ(IFNγ), interferon inducible protein-10(IP-10). chemokine receptor CXCR3 and their significance in infection-associated hemophagocytic syndrome(IAHPS). Methods Forty-three patients with IAHPS, 35 infection patients without HPS and 25 healthy controls were included in the study. The serum IFNγ and IP-10 levels were measured by enzyme linked immunosorbent assay(ELISA). The expression of CXCR3 on cell surface of CD_4~+ and CD_8~+ T cells in peripheral blood was determined by flow cytometry. SPSS 13.0 was used for data processing, and independent-sample t test was performed to compare the differences among the groups. Results The serum IFNγ and IP-10 levels in patients with IAHPS were( 608±135) pmol/L and(939±141) pmol/L respectively, which were significantly higher than those in without HPS group[(154±45) pmol/L and (385±119) pmol/L, t=4.97 and 4.02, P<0.05] and healthy controls[(56±18) pmol/L and (248±98) pmol/L, t=5.27 and 4.77, P<0.05]. The expressions of CXCR3 on CD_4~+ and CD_8~+ T cells in IAHPS group were (35±11)% and (23±8)% respectively, which were significantly higher than those in without HPS group[(24±7)% and (16±7)%, t=3.12 and 3.62, P<0.05] and healthy controls[(20±6)% and (12±5)%, t=4.46 and 4.93, P<0.05]. Conclusion The expressions of IFNγ, IP-10 and CXCR3 are increased significantly in patients with IAHPS, which may be related to the disease pathogenesis.