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目的研究IL-17、IL-23和TNF-α在吉兰-巴雷综合征(GBS)发病过程中的作用,及采用IVIG治疗后GBS患儿血清IL-17、IL-23和TNF-α水平的变化。方法将38例GBS患儿分为2组:A组,发病7 d内给予IVIG;B组,发病8～12 d给予IVIG;均给予IVIG 0.4 g·kg-1·d-1连续治疗5 d。采用ELISA法检测2组患儿血清IL-17、IL-23和TNF-α水平,并与健康对照组血清IL-17、IL-23和TNF-α水平进行比较。结果 GBS患儿治疗前血清中IL-17、IL-23和TNF-α水平较健康对照组显著升高(t=4.498～16.418,Pa<0.05);GBS患儿经IVIG治疗后,其血清IL-17、IL-23和TNF-α水平较用药前显著降低(Pa<0.05);A,B 2组治疗前血清IL-17、IL-23和TNF水平无显著性差异,治疗后血清IL-17、IL-23和TNF水平亦无显著性差异(Pa>0.05)。结论 GBS患儿急性期血清IL-17、IL-23和TNF-α水平升高,可能在GBS的发病中起重要作用,采用IVIG治疗后能有效抑制IL-17、IL-23和TNF-α分泌,从而控制GBS患儿的细胞炎症反应。
Objective To investigate the role of IL-17, IL-23 and TNF-α in the pathogenesis of Guillain-Barre syndrome (GBS) and to explore the role of IL-17, IL-23 and TNF-α Horizontal changes. Methods 38 children with GBS were divided into two groups: group A, IVIG was given within 7 days of onset; group B, IVIG was given from 8 to 12 days after the onset of treatment. All patients were given IVIG 0.4 g · kg-1 · d-1 for 5 days . Serum levels of IL-17, IL-23 and TNF-α in two groups were detected by ELISA, and compared with serum IL-17, IL-23 and TNF-α in healthy control group. Results Serum levels of IL-17, IL-23 and TNF-α in GBS children before treatment were significantly higher than those in healthy controls (t = 4.498-16.418, Pa <0.05) The levels of IL-17, IL-23 and TNF-α were significantly lower than those before treatment (P <0.05). There was no significant difference in serum IL-17, IL- 17, IL-23 and TNF levels were also no significant difference (Pa> 0.05). CONCLUSIONS: Elevated serum levels of IL-17, IL-23 and TNF-α in children with GBS may play an important role in the pathogenesis of GBS. After treatment with IVIG, the levels of IL-17, IL-23 and TNF- Secretion, and thus control the GBS children with cellular inflammatory response.