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目的探讨小儿慢性病贫血(ACD)时外周血肿瘤坏死因子(TNF)α、白介素(IL)6与红细胞生成素(EPO)的变化及其在发病机制中的作用。方法2002年4月至2004年12月常州市儿童医院收治ACD患儿19例(ACD组),采用放射免疫分析方法测定患儿外周血清中TNFα、IL6、EPO水平;对照组为17例上呼吸道感染恢复期患儿。结果与对照组比较,ACD组患儿血清中TNFα、IL6均显著增高(P<0.05)。血清TNFα、IL6与血清铁蛋白质量浓度呈正相关。结论免疫及炎症反应所产生的细胞因子TNFα、IL6可能通过干扰铁代谢和抑制EPO生成、钝化对EPO的反应等途径介导了ACD的发生和发展过程。
Objective To investigate the changes of tumor necrosis factor (TNF) α, interleukin (IL) 6 and erythropoietin (EPO) in peripheral blood of children with chronic anemia (ACD) and its role in pathogenesis. Methods From April 2002 to December 2004, 19 children with ACD (ACD group) were admitted to Changzhou Children’s Hospital. The levels of TNFα, IL6 and EPO in peripheral blood of children were measured by radioimmunoassay. The control group was 17 cases of upper respiratory tract Infection convalescent children. Results Compared with the control group, the serum levels of TNFα and IL6 in ACD group were significantly increased (P <0.05). Serum TNFα, IL6 and serum ferritin concentration was positively correlated. Conclusion The immune factors and inflammatory cytokines TNFα and IL6 may mediate the occurrence and development of ACD by interfering with iron metabolism and inhibiting the production of EPO and passivating the response to EPO.