【摘要】 目的 探讨以酮症酸中毒起病的儿童T1DM人血清IL-1β、IL-12、IL-18、TNF-α的改变。 方法 新诊断T1DM患者33例(T1DM组)，酮症酸中毒者18例;对照(NC)组27例。应用ELISA检测血清IL-1β、IL-12、IL-18、TNF-α水平。 结果 T1DM组IL-12水平高于NC组(P=0.000)。DKA组IL-12水平高于NDKA组(P=0.042)。H-LA组IL-1β水平高于N-LA组(P=0.031)。LC-P组IL-18水平高于NC-P组(P=0.041)。 结论 以酮症酸中毒起病的T1DM儿童Th1细胞因子水平升高，推测免疫紊乱可能与早期胰岛炎的发生相关，并在糖尿病发病初期起重要作用。

　　【关键词】糖尿病，1型;糖尿病酮症酸中毒;细胞因子

　　Changes in serum cytokine levels in T1DM children symptomized with diabetic ketoacidosis Lv Ling, Liu Jia-yue, Ma Jing, et al. Tianjin Children’s Hospital, Tianjin 300203, China

　　Corresponding author: lvlingzhuren @ 163.com

　　【Abstract】 Objective To investigate the changes in serum levels of interleukin (IL)-1β, IL-12, IL-18, and tumor necrosis factor alpha (TNF-α) in T1DM children symptomized with diabetic ketoacidosis (DKA). Methods The subjects consisted of 33 children with T1DM,18 with DKA, and 15 without DKA. Twenty-seven healthy children were served as controls. Levels of serum IL-1β, IL-12, IL-18, and TNF-α were measured by enzyme-linked immunosorbent assay (ELISA) tests. Results The serum IL-12 levels in newly diagnosed T1DM patients were significantly higher than in controls, P=0.000. The serum IL-12 levels were significantly higher in patients with DKA than those in patients without DKA, P=0.042. The serum IL-1βlevel was higher in patients with hyperlactacidemia than those in patients with normal lactate level, P=0.031. The serum IL-18 levels were significantly higher in patients with lower C-peptide (C-P) level than those in patients with normal C-P level, P=0.041. Conclusion Dysimmunity due to the increased level of TH1 cytokine in T1DM children symptomized with diabetic ketoacidosis may be correlated with inflammation of pancreatic islets in early stage, causing damages of β cells, and then resulting in diabetes.

　　【Key words】 Diabetes mellitus, type 1; Diabetic ketoacidosis; Cytokines