【摘要】 目的:探讨异基因造血干细胞移植前后血清细胞因子的变化与急性移植物抗宿主病(acute graftversushost disease,aGVHD)的关系。方法:采用放射免疫的方法测定59例异基因造血干细胞移植患者不同时间点血清细胞因子IL-1、IL-2、IL-4、TNF的浓度,并分析细胞因子与aGVHD的关系。结果:59例患者在干细胞输入后血清细胞因子IL-1、IL-2均升高,14例Ⅱ~ⅣaGVHD患者的IL-1、IL-2浓度明显高于45例0~ⅠaGVHD患者(P值均<0.01)。Ⅱ~ⅣaGVHD患者的各检测时间IL-4水平无显著性差异,0~ⅠaGVHD患者IL-4水平明显高于Ⅱ~ⅣaGVHD组(P<0.05)。0~ⅠaGVHD患者血清TNF浓度无显著变化,Ⅱ~ⅣaGVHD组21d TNF水平明显升高,而且高于0~ⅠaGVHD组(P<0.01)。患者细胞因子水平出现差异的时间(14 d~21 d)早于aGVHD的出现时间(中位时间28 d)。结论:造血干细胞移植后患者血清细胞因子的变化与aGVHD的发生发展有着明显的相关性,监测细胞因子的动态变化对预测aGVHD发生及严重程度有一定的作用。更多还原

【Abstract】 Objective:To explore the relationship between the serum levels of cytokines and acute graft-versus-host disease(aGVHD) in allogeneic hematopoietic stem cell transplantation.Methods:The serum levels of interleukin-1(IL-1),interleukin-2(IL-2),interleukin-4(IL-4),and tumor necrosis factor(TNF) of 59 patients were determined by radioimmunoassay at consecutive time points.The relationship between the serum levels of cytokines and aGVHD were analyzed.Results:The serum levels of IL-1 and IL-2 were both increased in all 59 patients after transplantation of allogeneic hematopoietic stem cells.They were significantly higher in patients who developed grade Ⅱ to Ⅳ aGVHD than those in patients who developed grade 0 to Ⅰ aGVHD(both P<0.01).The level of IL-4 in patients with grade Ⅱ to Ⅳ aGVHD had no significant difference at different time points,but it was significantly increased in patients with grade 0 to I aGVHD compared with that in patients with grade Ⅱ to Ⅳ aGVHD(P<0.05).The level of TNF in patients with grade 0 to Ⅰ aGVHD was not significantly different at different time points,whereas it was increased in patients with Ⅱ to Ⅳ aGVHD on d 21 which was significantly higher than patients with grade 0 to Ⅰ aGVHD(P<0.01).The changes in the serum levels of cytokines preceded the occurrence of aGVHD after stem cells transplantation(median time: 14 d to 21 d vs 28 d).Conclusion:The serum levels of cytokines closely correlated with the occurrence and severity of aGVHD and may be helpful for the prediction,diagnosis and monitoring of aGVHD.更多还原