Abstract: AbstractObjectiveTo explore the role of TNFα，IL6 and EPO in the pathogensis of anemia of chronic diseases (ACD) in children. MethodsThe levels of serum TNFα，IL6 and EPO were determined by immunoassays in 19 ACD patients. ResultsThe serum levels of TNFα，IL6 in ACD patients were significantly higher than those in the control group (P<0.05).There were a positive correlation between the serum levels of TNFα or IL6 and serum ferritin. ConclusionTNFα，IL6 resulting from immune and inflammatory reaction may play an important role in the development of ACD by intervening iron metabolism,inhibiting the generation of erythropoietin (EPO)and dulling the response of bone marrow to EPO.

Key words: Erythropoietin , Tumor necrosis factorα, Interleukin 6

摘要： 目的探讨小儿慢性病贫血(ACD)时外周血肿瘤坏死因子(TNF)α、白介素(IL)6与红细胞生成素(EPO)的变化及其在发病机制中的作用。 方法2002年4月至2004年12月常州市儿童医院收治ACD患儿19例(ACD组)，采用放射免疫分析方法测定患儿外周血清中TNFα、IL6、EPO水平；对照组为17例上呼吸道感染恢复期患儿。 结果与对照组比较，ACD组患儿血清中TNFα、IL6均显著增高(P<0.05)。血清TNFα、IL6与血清铁蛋白质量浓度呈正相关。 结论免疫及炎症反应所产生的细胞因子TNFα、IL6可能通过干扰铁代谢和抑制EPO生成、钝化对EPO的反应等途径介导了ACD的发生和发展过程。

关键词: 慢性病贫血, 肿瘤坏死因子α, 白细胞介素6, 红细胞生成素