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目的 检测多发性骨髓瘤(MM)(“免疫过度受抑”疾病)与系统性红斑狼疮(SLE)(“免疫过度激活”疾病)患者血浆白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)水平,并对结果进行分析。方法 SLE、MM患者和健康对照均于清晨空腹抽取静脉血3ml,酶联免疫法测定血浆IL-2、TNF-α水平。结果 与对照者比较,MM患者、SLE患者血浆IL-2水平差异无统计学意义;MM患者TNF-α水平显著低于对照者(P<0.05),SLE患者TNF-α水平显著高于对照者(P<0.05)。MM患者血浆IL-2、TNF-α水平显著低于SLE患者(P=0.01,P<0.01)。年龄<55岁组MM患者血浆IL-2、TNF-α均显著高于≥55岁组(P<0.01,P=0.03);肾功能不全MM患者血浆IL-2水平显著高于肾功能正常MM患者(P=0.01)。有与无首诊盘形红斑的SLE患者之间,其血浆IL-2、TNF-α水平差异有统计学意义(P=0.02,P=0.02)。结论TNF-α在体内微环境的生理失衡是MM患者的“免疫过度受抑”与SLE患者“免疫异常激活”的原因之一,IL-2的影响作用则有待进一步深入。
Objective To detect the levels of plasma interleukin-2 (IL-2), tumor necrosis factor (TNF) and interleukin-6 (IL-10) in patients with multiple myeloma (MM) -α (TNF-α) levels, and the results were analyzed. Methods SLE, MM patients and healthy controls were collected fasting blood samples 3ml fasting plasma levels of IL-2, TNF-α by enzyme-linked immunosorbent assay. Results There was no significant difference in plasma IL-2 levels between MM patients and SLE patients. The levels of TNF-α in MM patients were significantly lower than those in controls (P <0.05), and the levels of TNF-α in SLE patients were significantly higher than those in controls (P <0.05). The levels of plasma IL-2 and TNF-α in MM patients were significantly lower than those in SLE patients (P = 0.01, P <0.01). The levels of plasma IL-2 and TNF-α in patients with age <55 years old were significantly higher than those of patients aged ≥ 55 years (P <0.01, P = 0.03). The levels of plasma IL-2 in patients with renal insufficiency MM were significantly higher than those in patients with normal renal function Patients (P = 0.01). The levels of IL-2 and TNF-α in plasma of patients with SLE with or without first diagnosed erythema were statistically significant (P = 0.02, P = 0.02). Conclusions The physiological imbalance of TNF-α in vivo is one of the causes of “immune suppression” in patients with MM and “abnormal immune activation” in SLE patients. The effect of IL-2 remains to be further studied.