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目的探讨外周血单个核细胞核因子-κB(NF-κB)活性及相关炎性因子白介素-1β(IL-1β)、IL-6、IL-8、肿瘤坏死因子-α(TNF-α)、IL-4和IL-10在小儿多器官功能障碍综合征(MODS)中的作用及临床意义。方法2004-10—2005-06,于广州市儿童医院采用酶联免疫吸附法(ELISA)检测28例MODS患儿第1、3、7天3个时点外周血单个核细胞NF-κB活性,同时采用Luminex TM-100液相分析平台测定血清IL-1β、IL-6、IL-8、TNF-α、IL-4和IL-10质量浓度,并设立对照组20例。结果MODS患儿各时点单个核细胞NF-κB活性、血清IL-6、IL-10明显高于对照组(P<0.05),在存活组呈降低趋势而死亡组维持在高水平(P<0.05),TNF-α显著下降;NF-κB活性与TNF-α负相关(r=0.333,P=0.002),与IL-6正相关(r=0.292,P=0.007)。结论MODS患儿外周血单个核细胞NF-κB活性、血清IL-6、IL-10水平的持续升高预示预后不良。
Objective To investigate the effects of interleukin-1β (IL-1β), interleukin-6, interleukin-8, tumor necrosis factor-α (TNF- -4 and IL-10 in children with multiple organ dysfunction syndrome (MODS) and its clinical significance. Methods From 2004 to 2005, the activity of NF-κB in peripheral blood mononuclear cells of 28 children with MODS was detected by enzyme-linked immunosorbent assay (ELISA) Serum levels of IL-1β, IL-6, IL-8, TNF-α, IL-4 and IL-10 were measured by Luminex TM-100 liquid phase analysis platform. Results The levels of NF-κB, IL-6 and IL-10 in mononuclear cells in MODS children were significantly higher than those in control group (P <0.05), but decreased in survivors and remained high in death group (P < 0.05). TNF-αdecreased significantly. NF-κB activity was negatively correlated with TNF-α (r = 0.333, P = 0.002), and positively correlated with IL-6 (r = 0.292, P = 0.007). Conclusion The persistent increase of NF-κB activity, IL-6 and IL-10 levels in peripheral blood mononuclear cells of MODS children indicates the poor prognosis.