Th1/Th2类细胞因子在新型甲型H1N1流感重症患者不同预后转归中作用分析

摘要

目的 探讨细胞因子在新型甲型H1N1流感重症患者不同临床预后中作用。方法 2009年4月至2010年1月间北京佑安医院收治甲型H1N1流感重症患者28例（16例治疗痊愈，12例死亡）为研究对象，正常对照11例。Luminex技术检测血清中Th1/Th2细胞因子水平。结果 Th1类细胞因子中IL-2，IL-12 (P70)，IFN-γ水平在死亡组明显低于治愈组及正常组，差异有统计学意义，P值均＜ 0.05。Th2类细胞因子中IL-4水平在死亡组明显低于治愈组及正常组，P=0.0012，0.031。结论 新型H1N1感染重症治愈患者、死亡患者Th1类细胞因子水平均呈下降趋势，死亡组患者下降更为明显，Th1类细胞因子水平的严重减低可能与重症患者预后不良相关。%Objective To explore the effect of cytokine in the different prognosis of patients with severe influenza A ( H1N1 ) infection. Methods 28 cases with severe influenza A ( H1 N1 ) were enrolled in the study including 16 cured cases and 12 dead cases. The cytokine level in serum was detected by Luminex technology. Results The levels of IL-2, IL-12(P70) and IFN-γ in dead group was lower than cured and normal control group and the difference were significant, P ＜ 0.05, respectively. IL-4 level in the dead group was significantly lower than cured group and normal control group, P value was 0. 0310 and 0.0012, respectively. Conclusions The Th1 cytokine level in the severe 2009 epidemic H1N1 influeaze cases shows decreased trend, and the trend is more obvious in dead cases. The decrease of Th1 cytokine may be one of reasons leading to severe clinical situation and related with the bad prognosis.