再生障碍性贫血患儿血清中IL-17、IL-22表达及意义

发布时间：2019-02-15 21:29

【摘要】：目的本研究通过检测儿童再生障碍性贫血(aplastic anemia,AA)血清中白细胞介素17(interleukin-17,IL-17)、白细胞介素22(interleukin 22,IL-22)的表达,并比较免疫抑制治疗缓解及未缓解患儿治疗前IL-17、IL-22的平均水平,初步探讨两者在儿童再生障碍性贫血中的作用。方法1.收集2015年12月至2016年12月郑州大学第一附属医院儿科门诊及病房初诊60例再障患儿,分为重型再障(severe aplastic anemia,SAA)组和非重型再障(non-severe aplastic anemia,NSAA)组,SAA组20例,NSAA组40例。收集同期郑州大学第一附属医院体检的正常健康儿童25例为正常对照组。2.SAA组、NSAA组于确诊后治疗前抽取清晨空腹静脉血2ml,正常对照组抽取清晨空腹静脉血2ml,离心后获得血清储存于-80℃冰箱。3.ELISA方法检测SAA组、NSAA组、正常对照组血清中细胞因子IL-17、IL-22的表达。4.分析SAA组、NSAA组、正常对照组各组中IL-17与IL-22的相关性。5.随访行免疫抑制治疗(immunosuppressive therapy,IST)的患儿及免疫抑制治疗6个月时的疗效。6.所有数据均采用SPSS 21.0软件处理,各组间年龄比较采用Kruskal-Wallis秩和检验,各组间性别比较采用独立的多组二分类资料的卡方检验。计量资料采用均数±标准差(sx±)或中位数、四分位数表示。两独立样本均数比较采用t检验。多个样本均数比较采用单因素方差分析,两两比较采用LSD-t检验。两连续变量间相关性采用Perason相关分析,以α=0.05为检验水准。结果1.SAA组、NSAA组及正常对照组三组间年龄、性别无明显差异,差异无统计学意义(P0.05)。2.SAA组血清IL-17水平为(225.65±31.87)pg/ml,NSAA组为(198.37±42.66)pg/ml,均显著高于正常对照组(79.37±51.70)pg/ml,差异有统计学意义(P0.05)。SAA组IL-17水平高于NSAA组,两组比较差异有统计学意义(P0.05)。3.SAA组血清IL-22水平为(51.09±10.39)pg/ml,NSAA组为(38.99±10.25)pg/ml,均显著高于正常对照组(15.20±5.98)pg/ml,其差异有统计学意义(P0.05)。SAA组IL-22水平高于SAA组,两组比较差异有统计学意义(P0.05)。4.SAA组及NSAA组血清IL-17水平与IL-22水平均呈直线正相关(r=0.489,P=0.029,r=0.336,P=0.034),正常对照组血清IL-17水平与IL-22水平无明显相关性(r=0.169,P=0.42)。5.60例初诊再障患儿,50例行免疫抑制治疗(抗胸腺细胞球蛋白和/或环孢素A),随访至2017年3月,8例(2例SAA,6例NSAA)随访时间6个月。6个月评价疗效,24例部分/完全缓解,18例免疫抑制治疗后未缓解。行IST缓解患儿治疗前血清IL-17、IL-22平均水平均低于未缓解患儿(197.33±46.67pg/ml vs 219.55±29.15pg/ml,41.23±10.17pg/ml vs 44.74±10.95pg/ml),但差异无统计学意义(P0.05)。结论1.IL-17、IL-22在初诊再障中的表达升高,且SAA组IL-17、IL-22水平高于NSAA组,提示IL-17、IL-22可能参与儿童再障的发病,并可作为再障严重程度的评判指标。2.再障患儿IL-22的表达与IL-17呈正相关。3.再障患儿免疫抑制治疗有效,IL-17、IL-22的水平可能与治疗效果无关联。
[Abstract]:Objective to investigate the expression of interleukin 17 (interleukin-17,IL-17) and interleukin 22 (interleukin 22 IL-22) in the serum of children with aplastic anemia (aplastic anemia,AA). The average level of IL-17,IL-22 in children with remission and non-remission before treatment was compared, and the role of IL-17,IL-22 in children with aplastic anemia was discussed. Method 1. From December 2015 to December 2016, 60 newly diagnosed children with aplastic anemia in pediatric outpatient and ward of the first affiliated Hospital of Zhengzhou University were divided into severe aplastic anemia (severe aplastic anemia,SAA) group and non-severe aplastic anemia (non-severe aplastic anemia,NSAA) group, SAA group (20 cases). 40 cases in NSAA group. During the same period, 25 healthy children in the first affiliated Hospital of Zhengzhou University were collected as normal control group. In 2.SAA group, 2 ml of early morning fasting venous blood was taken from NSAA group and 2 ml of fasting venous blood was collected from normal control group before treatment. After centrifugation, the serum was stored in -80 鈩，

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