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目的:探讨高铝暴露再生障碍性贫血(AA)患者免疫细胞因子变化特点及其临床意义。方法:选取AA患者62例(病例组),根据患者居住地和饮用水铝含量分为高铝暴露组(33例)和非高铝暴露组(29例),高铝暴露地区和非高铝暴露地区健康体检者各30例作为对照组。利用ELISA法检测其治疗前后免疫细胞因子IL-10、IL-12、IL-17及INF-γ表达情况,ICP-MS方法检测血清铝的水平,分析高铝暴露AA患者治疗前后免疫细胞因子变化特点及临床意义。结果:高铝暴露人群(高铝暴露的AA患者及健康者)血清铝水平高于非高铝暴露人群(非高铝暴露的AA患者及健康者)(P<0.01),且高铝暴露AA患者血清铝水平高于高铝暴露健康者(P<0.01)。治疗前病例组(高铝暴露AA及非高铝AA)IL-10水平显著低于对照组,IFN-γ、IL-17水平显著高于对照组(均P<0.01)。治疗前高铝暴露AA组IL-10、IFN-γ水平高于非高铝暴露AA组和对照组(均P<0.05)。高铝暴露AA组IL-17水平高于对照组(P<0.01),但与非高铝暴露AA组比较差异无统计学意义。治疗后病例组IL-10水平较治疗前显著升高,IFN-γ、IL-17水平均较治疗前显著下降(均P<0.05)。IL-12在病例组内、病例组与对照组间比较均未发现差异有统计学意义。血清铝水平与细胞因子间未发现相关性。结论:高铝暴露AA与非高铝暴露AA免疫细胞因子表达水平有所不同,高铝暴露可影响免疫细胞因子水平。
Objective: To investigate the characteristics and clinical significance of immune cytokines in patients with high aluminum exposure and aplastic anemia (AA). Methods: 62 AA patients (case group) were selected and divided into high aluminum exposure group (n = 33) and non-high aluminum exposure group (n = 29) according to their residence and drinking water content. 30 healthy subjects were exposed as the control group. The expression of IL-10, IL-12, IL-17 and INF-γ were measured by ELISA before and after treatment. The levels of serum aluminum were measured by ICP-MS. The changes of immune cytokines Characteristics and clinical significance. Results: The levels of serum aluminum in high-aluminum exposure groups (AA patients with high aluminum exposure and healthy subjects) were significantly higher than those in non-high-aluminum exposure groups (AA patients without high aluminum exposure and healthy subjects) (P <0.01) Patients with serum aluminum levels were higher than those exposed to high aluminum (P <0.01). The levels of IL-10 in pre-treatment cases (AA exposure and non-AA exposure) were significantly lower than those in control group, and the levels of IFN-γ and IL-17 were significantly higher than those in control group (all P <0.01). Before treatment, the levels of IL-10 and IFN-γ in AA group were higher than those in AA group and control group (all P <0.05). The level of IL-17 in AA group was higher than that in control group (P <0.01), but there was no significant difference between AA group and non-AA exposure group. After treatment, the levels of IL-10 in patients were significantly higher than those before treatment, and the levels of IFN-γ and IL-17 were significantly lower than those before treatment (all P <0.05). IL-12 in the case group, the case group and control group were found no significant difference between the statistically significant. No correlation was found between serum aluminum levels and cytokines. CONCLUSION: The AA immunocompetent cells exposed to high-aluminum exposure differ from those exposed to non-high-aluminum exposure. Exposure to high-aluminum may affect the level of immune cytokines.