脓毒症患者血清相关细胞因子检测及意义  

Cytokines of serum related detection and significance in septic patients

作　　者：杨倩[1] 刘黎[1] 马娣[1] 朱长清[1] 陆晓晔[1] 

机构地区：[1]上海交通大学医学院附属仁济医院急诊科,上海200127

出　　处：《临床急诊杂志》2017年第12期907-911,共5页Journal of Clinical Emergency

基　　金：上海市卫生和计划生育委员会科研计划项目(No:201540245)

摘　　要：目的:探讨脓毒症患者血清中与T细胞相关的细胞因子、趋化因子等的水平,评价脓毒症患者的免疫情况以及与脓毒症的关系。方法:收集2012-01-2017-06期间入住我院急诊科112例脓毒症患者以及同期体检中心40例健康体检患者,通过Luminex Bio-plex悬液芯片系统检测多细胞因子IL-4、IL-5、IL-6、IL-7、IL-8、GCSF、GM-CSF、IFN-γ、IL-1β、IL-2、IL-10、IL-12、IL-13、IL-17、MCP-1、MIP-1β、TNF-α浓度,对两组患者整体验证后进行比较分析。结果:(1)两组患者的临床特征比较显示性别构成、年龄、总胆红素均差异无统计学意义,白细胞计数、血肌酐、谷丙转氨酶、CRP、PCT、低密度脂蛋白显著高于正常对照组(P<0.05或P<0.01),甘油三酯、胆固醇、高密度脂蛋白、白蛋白在脓毒症组要显著低于正常对照组(P<0.05或P<0.01);(2)细胞因子IL-1β、IL-5、IL-17浓度在两组间均差异无统计学意义,而脓毒症组趋化因子MCP-1、MIP-1β、IL-8和集落刺激因子G-CSF、GM-CSF、TNF-α以及细胞因子IFN-γ、IL-4、IL-6、IL-7、IL-2、IL-10、IL-12、IL-13浓度显著高于正常对照组(P<0.05)。结论:脓毒症患者IL-4、IL-6、IL-7、IL-8、G-CSF、GM-CSF、IFN-γ、IL-2、IL-10、IL-12、IL-13、MCP-1、MIP-1β、TNF-α浓度显著高于正常对照组,这些细胞因子可能对脓毒症的早期诊断有指导意义。Objective：To evaluate immune conditions and its relationships with sepsis in septic patients by exploring the serum levels of cytokines and chemokines associated with T-cell in these patients.Method：A total of 112 septic patients admitted to the emergency department in our hospital from January 2012 to June 2017 were enrolled in septic group.Another 40 healthy people were chosen as controls at the same time.Cytokine concentrations in serum,including IL-4、IL-5、IL-6、IL-7、IL-8、G-CSF、GM-CSF、IFN-γ、IL-1β、IL-2、IL-10、IL-12、IL-13、IL-17、MCP-1、MIP-1β and TNF-α,were assessed with Luminex Bio-plex system in both of groups.Result：（1）No difference in gender,age and serum level of total bilirubin was observed between septic group and control group（P〈0.05）,Whereas,serum levels of white blood cell count,creatinine,cereal third transaminase,CRP,PCT,and lowdensity lipoprotein,were significantly higher in septic group（P〈0.05 or P〈0.01）,while serum levels of triglyceride,cholesterol,high-density lipoprotein and albumin in septic group were significantly lower than those in control group（P〈0.05 or P〈0.01）.（2）The serum cytokines including IL-1β、IL-5 and IL-17 in the two groups did not differ,however,the chemokines including MCP-1、MIP-1β and IL-8,colony stimulating factors including GCSF、GM-CSF and TNF-α,and cytokines including IFN-γ、IL-4、IL-6、IL-7、IL-2、IL-10、IL-12、IL-13 in septic group were significantly higher than those in control group（P〈0.05）.Conclusion：The serum cytokines which include IL-4、IL-6、IL-7、IL-8、G-CSF、GM-CSF、IFN-γ、IL-2、IL-10、IL-12、IL-13、MCP-1、MIP-1β、TNF-α in septic patients were significantly higher than those of control group.As a result,the cytokines mentioned above may have guiding significance when it comes to early diagnosis of sepsis.

关 键 词：脓毒症 细胞因子 早期诊断 

分 类 号：R631[医药卫生—外科学]