不同型别登革热病例细胞因子及肝功能表达水平研究

目的 通过检测不同型别输入性登革热患者血中细胞因子及肝功能的水平,探讨细胞因子与肝功能的相关性。方法 对2012—2018年昆明市第三人民医院收治的登革热病例进行回顾性分析。采用实时荧光PCR法进行登革热核酸检测及分型;采用流式细胞术检测IL-2、IL-4、IL-6、IL-10、TNF-α、INF-γ,采用循环酶法检测肝功能;进行同型别早期与恢复期的比较及不同型别之间早期的比较。分析不同型别登革热患者细胞因子、肝功能的表达差异及指标的相关性。结果 78例登革热患者均来自南亚、东南亚,41例DENV1,9例DENV2,13例DENV3,15例DENV4;主要临床表现均为发热、头痛、肌肉关节痛、眼眶痛、出血、皮疹。与DENV1相比,DENV4的肌肉关节疼痛差异有统计学意义（P<0.05）,DENV2及DENV4的出血差异有统计学意义（P<0.05）。四型登革热早期的细胞因子、肝功与恢复期比较差异有统计学意义（P<0.05）;DENV3及DENV4早期的AST值及DENV2、DENV3、DENV4早期的ALT值,与DENV1早期比较差异均有统计学意义（P<0.05）;DENV1中IL-2、IL-4、IL-6和AST、ALT呈正相关,IL-10与AST呈负相关。结论 四型登革热病例均来自南亚、东南亚,以DENV1流行为主。四型早期细胞因子均与免疫损伤有关;DENV1比其他型别造成的肝损伤更明显,DENV1的IL-2、IL-4、IL-6与肝损伤呈正相关。

Correlation of cytokines and liver function in the different types of dengue fever

ObjectiveBy measuring the level of cytokines and liver function in the blood of patients with dengue fever of different types,to discuss the correlation between cytokines and liver function. MethodsDengue fever cases admitted to Kunming Third People's Hospital from 2012 to 2018 were retrospectively analyzed. Real-time fluorescence PCR was used to detect and classify dengue virus nucleic acid.Flow cytometry was used to detect IL-2, IL-4, IL-6, IL-10, TNF-α, and INF-γ.The early stage of the same type and the recovery stage and the early stage of different types were compared.The expression differences of cytokines and liver function in different types of dengue fever patients and the correlation of the indexes were analyzed. Results Totally 78 cases of dengue fever patients are from South Asia, Southeast Asia, 41 cases of DENV1, 9 cases DENV2, 13 cases DENV3, 15 cases DENV4.The main clinical manifestations were fever, headache, muscle and joint pain, orbital pain, bleeding, and rash.Compared with DENV1, there was a statistically significant difference in muscle and joint pain in DENV4 (P<0.05) and bleeding in DENV2 and DENV4 (P<0.05).The cytokines, liver function of early stage of the four types of dengue fever were significantly different with convalescence（P<0.05）. In the early stage, DENV3 and DENV4 AST values,and DENV2, DENV3, DENV4 ALT values, have significant difference compared with DENV1（P<0.05）;DENV1 of IL-2, IL-4, IL-6 and AST, ALT were positively correlated, IL-10 and AST were negatively correlated. Conclusion All cases of dengue fever type 4 are from South and Southeast Asia, DENV1 mainly prevails.Early stage, cytokines of the four types of dengue fever are associated with immune damage.DENV1 causes more liver damage than other types. IL-2, IL-4 and IL-6 of DENV1 are positively correlated with liver injury.