儿童急性呼吸窘迫综合征患儿血清肿瘤坏死因子-α与白细胞介素-1β，-6表达水平及其临床意义研究

doi:10.3877/cma.j.issn.1673-5250.2015.01.009

目的

观察儿童急性呼吸窘迫综合征(ARDS)患儿血清肿瘤坏死因子(TNF)-α与白细胞介素(IL)-1β，-6水平及其临床意义。

方法

选择2014年1～7月商丘市第一人民医院收治的ARDS患儿90例为研究对象，纳入研究组。根据柏林(2012年)ARDS病情严重程度诊断标准，将研究组患儿分为轻度亚组(n＝34)、中度亚组(n＝29)及重度亚组(n＝27)。选择同期在相同医院体检的健康儿童90例，纳入对照组。采取酶联免疫吸附法测定研究组及其各亚组与对照组受试者血清TNF-α与IL-1β，-6水平。采用统计学方法分析研究组及其各亚组与对照组受试者血清TNF-α与IL-1β，-6水平，并探讨TNF-α与IL-1β，-6水平变化的临床意义。本研究遵循的程序符合商丘市第一人民医院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象监护人的知情同意，并与其签署临床研究知情同意书。研究组与对照组之间及不同亚组之间病情严重程度、患儿年龄、性别构成等一般临床资料比较，差异均无统计学意义(P>0.05)。

结果

研究组血清TNF-α与IL-1β，-6水平均显著高于对照组，并且差异均有统计学意义(P<0.05)。研究组中，重度亚组、中度亚组患儿血清TNF-α与IL-1β，-6水平均显著高于轻度亚组，并且差异均有统计学意义(P<0.05)；而重度亚组患儿的血清TNF-α与IL-1β，-6水平显著高于中度亚组，差异亦有统计学意义(P<0.05)。

结论

ARDS患儿血清TNF-α与IL-1β，-6水平均较正常儿童显著升高，且病情愈重，TNF-α与IL-1β，-6水平愈高，临床应予以重视。

关键词: 呼吸窘迫综合征，急性, 病情严重程度, 肿瘤坏死因子-α, 白细胞介素-6, 白细胞介素-1β, 儿童

Objective

To study levels of serum tumor necrosis factor (TNF)-α, interleukin(IL)-1β, -6 in children with acute respiratory distress syndrome (ARDS) and its clinical significance.

Methods

From January to July 2014, a total of 90 cases of children with ARDS who treatment in Shangqiu First People's Hospital were included into study group. During the same period, a total of 90 cases of healthy children who had physical examination at the same hospital were included into control group. According to diagnostic criteria of severity of ARDS in Berlin(2012), study group were divided into mild subgroup(n=34), moderate subgroup (n=29), and severe subgroup (n=27). Levels of serum TNF-α, IL-1β, -6 were detected by enzyme linked immunosorbent assay. Statistically analyzed levels of serum TNF-α, IL-1β, -6 in study group, its different subgroups and control group, and explored clinical significance of changes in levels of serum TNF-α, IL-1β, -6. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Shangqiu First People's Hospital. Informed consent was obtained from each participant's guardian. There were no significant differences between study group and control group, among mild, moderate, and severe subgroup in gender and age of children(P>0.05).

Results

In study group, levels of serum TNF-α and IL-1β, -6 were significantly higher than those in control group, and there were significant differences (P<0.05). In study group, levels of serum TNF-α and IL-1β, -6 in moderate and severe subgroup were much higher than those in mild subgroup, and there were significant differences (P<0.05); levels of serum TNF-α and IL-1β, -6 levels in severe subgroup were much higher than those in moderate subgroup, and there were significant differences (P<0.05).

Conclusions

Levels of serum TNF-α, IL-1β, -6 in children with ARDS were much higher than those in healthy children, the more serious of ARDS, the higher levels of serum TNF-α and IL-1β, -6. Clinicians should pay more attention to these.

Key words: Respiratory distress syndrome, acute, Severity of illness, Tumor necrosis factor-alpha, Interleukin-6, Interleukin-1 beta, Child

表1 研究组与对照组血清TNF-α与IL-1β，-6水平比较(pg/mL，±s)

Table 1 Comparison of levels of serum TNF-α and IL-1β，-6 between study group and control group(pg/mL，±s)

组别	例数	TNF-α	IL-1β	IL-6
研究组	90	543.7±79.4	132.6±29.7	237.4±54.6
对照组	90	247.5±67.4	21.3± 4.9	32.1±12.4
t值	?	5.974	11.255	13.759
P值	?	<0.05	<0.05	<0.05

表1 研究组与对照组血清TNF-α与IL-1β，-6水平比较(pg/mL，±s)

Table 1 Comparison of levels of serum TNF-α and IL-1β，-6 between study group and control group(pg/mL，±s)

组别	例数	TNF-α	IL-1β	IL-6
研究组	90	543.7±79.4	132.6±29.7	237.4±54.6
对照组	90	247.5±67.4	21.3± 4.9	32.1±12.4
t值	?	5.974	11.255	13.759
P值	?	<0.05	<0.05	<0.05

表2 研究组中，重度亚组、中度亚组及轻度亚组患儿血清TNF-α与IL-1β，-6水平比较(pg/mL，±s)

Table 2 Comparison of levels of serum TNF-α and IL-1β，-6 among severe, moderate and mild subgroup in study group (pg/mL，±s)

组别	例数	TNF-α	IL-1β	IL-6
重度亚组	27	642.6±84.5	143.6±34.5	276.4±65.2
中度亚组	29	557.9±76.3	129.6±26.9	249.9±55.4
轻度亚组	34	436.7±65.2	113.2±21.4	211.9±45.2
t值	?	7.952^a	6.447^a	5.608^a
?	?	9.762^b	8.552^b	6.462^b
?	?	5.374^c	4.736^c	4.200^c

表2 研究组中，重度亚组、中度亚组及轻度亚组患儿血清TNF-α与IL-1β，-6水平比较(pg/mL，±s)

Table 2 Comparison of levels of serum TNF-α and IL-1β，-6 among severe, moderate and mild subgroup in study group (pg/mL，±s)

组别	例数	TNF-α	IL-1β	IL-6
重度亚组	27	642.6±84.5	143.6±34.5	276.4±65.2
中度亚组	29	557.9±76.3	129.6±26.9	249.9±55.4
轻度亚组	34	436.7±65.2	113.2±21.4	211.9±45.2
t值	?	7.952^a	6.447^a	5.608^a
?	?	9.762^b	8.552^b	6.462^b
?	?	5.374^c	4.736^c	4.200^c

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Study of clinical significance on levels of serum tumor necrosis factor-α and interleukin-1β, -6 in children with acute respiratory distress syndrome

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Study of clinical significance on levels of serum tumor necrosis factor-α and interleukin-1β, -6 in children with acute respiratory distress syndrome