脓毒血症患者炎性因子及免疫指标与疾病严重程度的相关性研究

doi:10.3969/j.issn.1671-2587.2020.01.024

临床输血与检验 ›› 2020, Vol. 22 ›› Issue (1): 100-103.DOI: 10.3969/j.issn.1671-2587.2020.01.024

脓毒血症患者炎性因子及免疫指标与疾病严重程度的相关性研究

肖勇, 夏正新, 方玉明

201900 上海交通大学医学院附属第九人民医院

收稿日期:2018-07-20 出版日期:2020-02-20 发布日期:2020-02-28
作者简介:肖勇(1984-),男,安徽安庆人,医师,学士,主要从事急诊创伤性研究,(Tel)13916712568(E-mail)xiaoyong373@163.com。

Correlation of Inflammatory Cytokines and Indicators of Immunity with Severity of the Patients with Sepsis

XIAO Yong, XIA Zheng-xin, FANG Yu-ming

Department of Emergency,The Ninth Hospital of Shanghai Jiaotong University School of Medicine,Shanghai 201900

Received:2018-07-20 Online:2020-02-20 Published:2020-02-28

摘要/Abstract

摘要： 目的探讨脓毒血症患者血液中炎性指标(IL-6、IL-10、PCT、CRP、NEUT)及免疫指标(CD4+、CD8+、CD4+/CD8+)的变化,以判断脓毒血症病情严重程度的关联性。方法选取2015年9月~2017年2月该院收治的脓毒血症患者54例,根据APACHE-II评分判断病情程度分为脓毒血症组18例,严重脓毒血症组19例,脓毒性休克组17例。比较分析各组患者血清PCT、CRP、 IL-6、IL-10、WBC、NEUT水平,以及CD4+、CD8+、CD4+/CD8+的变化与各组患者的急性生理和慢性健康评分(APACHE-Ⅱ)的相关性。结果随着脓毒血症病情的加重,脓毒血症患者血清PCT、CRP、IL-6、IL-10、WBC、NEUT水平逐渐升高,而免疫指标(CD4+、CD8+、CD4+/CD8+)下降(P<0.05),脓毒血症患者血液中炎症指标PCT、CRP、IL-6、IL-10、WBC与APACHE-Ⅱ评分呈正相关(r=0.778,0.654,0.685,0.541,0.532,P<0.05),而免疫功能(CD4+、CD8+、CD4+/CD8+)与APACHE-Ⅱ评分呈负相关(r=-0.676,-0.517,-0.612,P<0.05)。结论患者血液中炎性指标(CRP、 PCT、IL-6、IL-10、WBC)呈高表达状态,而免疫功能低下(CD4+、CD8+),提示脓毒血症病情的加重。

关键词: 脓毒血症, 炎性指标, 免疫功能

Abstract: Objective To investigate the change of cytokines (IL-6, IL-10, PCT, CRP, and NEUT) and the indicators of immunity (CD4+, CD8+, CD4+/CD8+) in the patients with sepsis so as to determine the association of the markers with severity of the disease. Methods Fifty-four patients were divided into moderate group (18 cases), severe group (19 cases) and septic shock group (17 cases). The levels of serum IL-6, IL-10, PCT, and CRP, the counts of WBC, NEUT, CD4+, and CD8+, and the ratio of CD4+ /CD8+ were measured in all of the patients and the correlation between the data and acute physiology and chronic health evaluation (APACHE- II) was compared. Results The levels of PCT, CRP, IL-6, and IL-10, the counts of WBC and NEUT increased gradually, and the indicators of immunity (the number of CD4+ and CD8+, and the ratio of CD4+/CD8+) decreased (P<0.05) with exacerbation of sepsis. The levels of PCT, CRP, IL-6, IL-10, and the count of WBC in the patients were positively correlated with APACHE- II scores (P<0.05). As the contrary, the numbers of CD4+ and CD8+, and the ratio of CD4+/CD8+ were negatively correlated with APACHE- II scores (P<0.05). Conclusion The inflammatory markers of PCT, CRP, IL-6, and IL-10 as well as the count of WBC in septic patients were elevated while the numbers of CD4+ and CD8+, and the ratio of CD4+/CD8+ decreased with deterioration of the disease.

Key words: Sepsis, Inflammatory cytokines, Indicators of immunity

中图分类号:

R459.7

肖勇, 夏正新, 方玉明. 脓毒血症患者炎性因子及免疫指标与疾病严重程度的相关性研究[J]. 临床输血与检验, 2020, 22(1): 100-103.

XIAO Yong, XIA Zheng-xin, FANG Yu-ming. Correlation of Inflammatory Cytokines and Indicators of Immunity with Severity of the Patients with Sepsis[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2020, 22(1): 100-103.

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脓毒血症患者炎性因子及免疫指标与疾病严重程度的相关性研究

Correlation of Inflammatory Cytokines and Indicators of Immunity with Severity of the Patients with Sepsis

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