Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
Pediatr Infect Dis J. 2009 Oct;28(10):885-90. doi: 10.1097/INF.0b013e3181a39e23.
Interleukin (IL)-8 acts as a potent neutrophils chemoattractant responsible for the migration of neutrophils into the infected renal tissue to protect against invading pathogens. The aim of this study was to assess the role of IL-8 on acute-phase pyelonephritis and later renal scarring in children.
A total of 124 children with a first-time febrile urinary tract infection (UTI) were studied. The diagnosis of acute pyelonephritis was confirmed by Tc-dimercaptosuccinic acid (DMSA) renal scan. Serum and urine samples were obtained from 124 children with UTI and 20 healthy children for IL-8 measurement.
The 124 children were divided into acute pyelonephritis (n = 70) and lower UTI (n = 54) groups according to the results of DMSA scans. The initial serum and urine IL-8 values of children with acute pyelonephritis were significantly higher when compared with lower UTI and healthy controls (all P < 0.001). Renal scarring was seen in 26 (38.8%) of these 67 children with acute pyelonephritis at follow-up DMSA scans. Both the initial serum and urine IL-8 concentrations were significantly higher in children with renal scarring than in those without (both P < 0.001). The mean age of children with renal scarring was also significantly lower than those without scarring (P = 0.004). Multivariate analysis showed that the highest initial IL-8 values, age <20 months and reflux grades > or =III all were independent predictors of renal scarring.
Those children younger than 2 years of age with the highest IL-8 concentrations during the acute phase of pyelonephritis as well as children with reflux grades of III or greater are at a high-risk for developing renal scarring in the future.
白细胞介素（IL）-8 作为一种有效的中性粒细胞趋化因子，可促使中性粒细胞迁移至感染的肾组织，以抵御入侵的病原体。本研究旨在评估 IL-8 在儿童急性肾盂肾炎及随后肾瘢痕形成中的作用。
共对 124 例首次出现发热性尿路感染（UTI）的儿童进行了研究。采用 Tc-二巯丁二酸（DMSA）肾扫描诊断急性肾盂肾炎。从 124 例 UTI 患儿和 20 例健康儿童中采集血清和尿液样本，用于 IL-8 测量。
根据 DMSA 扫描结果，将 124 例儿童分为急性肾盂肾炎（n = 70）和下尿路感染（n = 54）两组。急性肾盂肾炎患儿的初始血清和尿液 IL-8 值明显高于下尿路感染和健康对照组（均 P < 0.001）。在这些 67 例急性肾盂肾炎患儿中，有 26 例（38.8%）在随访 DMSA 扫描时发现肾瘢痕。有肾瘢痕的患儿的初始血清和尿液 IL-8 浓度均明显高于无瘢痕者（均 P < 0.001）。有瘢痕的患儿的平均年龄也明显低于无瘢痕者（P = 0.004）。多变量分析显示，初始 IL-8 值最高、年龄 <2 岁和反流分级 >或= III 均为肾瘢痕形成的独立预测因素。
在肾盂肾炎急性期，年龄 <2 岁且 IL-8 浓度最高的儿童以及反流分级为 III 或更高的儿童，将来发生肾瘢痕形成的风险较高。
