儿童急性白血病患者细胞因子IL-2和IL-10水平变化的临床研究

发布时间：2018-06-23 23:25

本文选题：儿童 + 急性白血病　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨急性白血病(acute leukemia,AL)患儿初步诊断时和化疗完全缓解(complete remission,CR)后血清中白介素2(interleukin-2,IL-2)、白介素10(interleukin-10,IL-10)含量的变化。方法:收集确诊为急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)和急性髓细胞性白血病(acute myelocytic leukemia,AML)且经过化疗获得完全缓解的患儿分别30例、13例及健康儿童20例,采用流式细胞术(flow cytometry method,FCM)测量初诊组、CR组、对照组血清中IL-2、IL-10的值,比较化疗前后及ALL组和AML组之间这两种细胞因子含量的变化,并分别与健康对照组做对比。结果:1.ALL组初诊1组IL-2水平(3.59±1.18)pg/ml与对照组IL-2水平(6.22±2.03)pg/ml相比较明显下降(P0.001),初诊1组IL-10的水平(15.88±4.73)pg/ml与正常儿童IL-10的水平(5.69±3.44)pg/ml相比较则显著升高(P0.001)。随着化疗的进行IL-2水平(4.78±1.57)pg/ml明显上升(P=0.005),IL-10水平(8.14±2.82)pg/ml显著下降(P0.001),都未达到正常儿童水平(P=0.034和P=0.036)。差异均有统计学意义(P0.05)。2.AML组初诊2组患儿IL-2水平(2.43±1.61)pg/ml与正常对照组儿童IL-2水平(6.22±2.03)pg/ml相比较明显下降(P0.001),初诊2组IL-10的水平(35.21±13.19)pg/ml与正常儿童IL-10的水平(5.69±3.44)pg/ml相比较则显著升高(P0.001)。随着化疗的进行IL-2水平(4.24±1.93)pg/ml明显上升(P=0.048),IL-10水平(12.06±3.81)pg/ml显著下降(P0.001),都未达到正常儿童水平(P=0.026和P0.001)。差异均有统计学意义(P0.05)。3.ALL组和AML组的比较初诊时和CR后ALL和AML患儿IL-2水平相比较差别不大(P=0.165和P=0.932);差异无统计学意义(P0.05)。而AML患儿IL-10水平明显高于ALL患儿水平(P=0.001和P=0.022),差异有统计学意义(P0.05)。结论:1.IL-2和IL-10含量的变化在AL患儿的发病及病情进展中至关重要。2.AL患儿体内的免疫功能状态可能随着IL-2和IL-10水平的起伏而不断变化,这两种细胞因子可作为病情评估的指标。3.AML患儿IL-10含量高与其预后差密切相关。
[Abstract]:Objective: to investigate the changes of serum interleukin-2 (IL-2) and interleukin-10 (IL-10) levels in children with acute leukemia (AL) at the time of initial diagnosis and after complete remission of chemotherapy (complete remissions). Methods: 30 cases of acute lymphoblastic leukemia (acute lymphoblastic leukemiaall) and 30 cases of acute myeloid leukemia (acute myelocytic leukemia all) and 20 healthy children with complete remission after chemotherapy were collected. Flow cytometry (FCM) was used to measure the level of IL-2 / IL-10 in the serum of CR group and control group. The changes of cytokines before and after chemotherapy and between all group and AML group were compared, and compared with those in healthy control group. Results the level of IL-2 in all group (3.59 卤1.18) pg/ml was significantly lower than that in control group (6.22 卤2.03) pg/ml (P0.001), and the level of IL-10 in newly diagnosed group (15.88 卤4.73) pg/ml was significantly higher than that in normal children (5.69 卤3.44) pg/ml (P0.001). The level of IL-2 (4.78 卤1.57) pg/ml increased significantly (P0. 005) and the level of IL-10 (8. 14 卤2. 82) pg/ml decreased significantly (P0. 001), and did not reach the level of normal children (P0. 034 and P0. 036). The level of IL-2 in newly diagnosed children in AML group (2.43 卤1.61) was significantly lower than that in normal control group (6.22 卤2.03) pg/ml (P0.001). The level of IL-10 pg/ml in newly diagnosed group (35.21 卤13.19) was significantly higher than that in normal children (5.69 卤3.44) pg/ml (P0.001). The level of IL-2 (4.24 卤1.93) pg/ml increased significantly (P0. 048) and the level of IL-10 (12. 06 卤3. 81) pg/ml decreased significantly (P0. 001), and did not reach the level of normal children (P0. 026 and P0. 001). The difference between all group and AML group was statistically significant (P0.05). 3. There was no significant difference in IL-2 level between all and AML children at first diagnosis and after CR (P0. 165 and P0. 932), but the difference was not statistically significant (P0.05). The level of IL-10 in AML children was significantly higher than that in all children (P0. 001 and P0. 022), and the difference was statistically significant (P0.05). Conclusion the changes of IL-2 and IL-10 levels are very important in the pathogenesis and progression of children with AL. 2.The immune function of children with AL may change with the fluctuation of IL-2 and IL-10 levels. These two cytokines can be used as an index to evaluate the condition. 3. The high level of IL-10 is closely related to poor prognosis in children with AML.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R733.71

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