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目的①研究血清、腹腔渗液中白细胞介素6(interleukin-6,IL-6)的水平在小儿急性阑尾炎诊断及严重程度分型中的价值;②探讨IL-6基因启动子-174G/C、-572G/C位点的多态性与小儿急性阑尾炎严重程度的关系。方法选取101例急性阑尾炎患儿,依据病理诊断分为普通组(单纯/化脓)、重症组(坏疽/穿孔)两组,以健康儿童为对照,ELISA法检测血清及腹腔渗液中IL-6浓度,用PCR-RFLP并测序法确定IL-6基因启动子的基因型。应用SPSS10.0统计软件对原始数据进行统计学处理。结果①普通组及重症组血IL-6浓度均明显高于对照组,P<0.01;重症组血IL-6浓度明显高于普通组P<0.01;重症组腹腔渗液IL-6、血C反应蛋白的浓度明显高于普通组,发病时间明显长于普通组,P<0.01。②重症组-572CC型频率明显高于普通组,P=0.011;三组间-174位点基因型频率的差异无显著性意义。③重症组及对照组-572CC型患儿血清IL-6表达水平明显高于-572G携带型,P<0.05;普通组-572CC型血清IL-6的表达水平高于-572G携带者,P=0.056。④logistic regression多因素分析结果表明-572位点的基因型、发病时间(症状出现至手术)与重症阑尾炎的发生有关。结论①IL-6有助于小儿急性阑尾炎的诊断及严重程度分型。但非急性阑尾炎或急性重症阑尾炎的特异性检测指标;②IL-6基因启动子-572位点CC型与小儿重症阑尾炎发生有关,IL-6基因-572C等位基因调控转录及表达的具体机制尚需进一步研究。
Objectives ① To study the value of interleukin-6 (IL-6) in serum and peritoneal effusion in the diagnosis and severity of acute appendicitis in children; ② to explore the role of IL-6 gene promoter -174G / C , -572G / C locus polymorphism and the severity of acute appendicitis in children. Methods A total of 101 children with acute appendicitis were selected and divided into normal group (simple / purulent) and severe group (gangrene / perforation) according to pathological diagnosis. Healthy children were taken as control. IL-6 The genotypes of IL-6 gene promoter were determined by PCR-RFLP and sequencing. Apply SPSS10.0 statistical software to the original data for statistical processing. Results ① The levels of IL-6 in the common group and the severe group were significantly higher than those in the control group (P <0.01), the levels of IL-6 in the severe group were significantly higher than those in the normal group (P <0.01) The concentration of reactive protein was significantly higher than the normal group, the onset time was significantly longer than the normal group, P <0.01. ② The frequency of -572CC in severe group was significantly higher than that in general group (P = 0.011). There was no significant difference in genotype frequency between the three groups at -174 locus. ③ Serum levels of IL-6 in severe group and control group-572CC were significantly higher than those in -572G group (P <0.05). The serum level of IL-6 in general group -572CC was higher than that in -572G group (P = 0.056. ④logistic regression multivariate analysis showed -572 locus genotype, onset time (symptoms appear to surgery) and the occurrence of severe appendicitis. Conclusion ①IL-6 is helpful to the diagnosis and severity of acute appendicitis in children. But non-acute appendicitis or acute severe appendicitis specific detection index; ② IL-6 gene promoter -572 CC type and pediatric severe appendicitis, IL-6 gene -572C allele regulation transcription and expression of the specific mechanism Need further study