创伤性脓毒症患者白细胞介素-35的表达及其与降钙素原、T细胞和预后的关系  

Expression of interleukin-35 in patients with traumatic sepsis and its relationship with Procalcitonin,T cells and prognosis

作　　者：蒋文[1] 周玉玲[1] 张颜彦 JIANG Wen;ZHOU Yu-ling;ZHANG Yan-yan(Chongqing Traditional Chinese Medicine Hospital,Chongqing 400020,China)

机构地区：[1]重庆市中医院急诊ICU,重庆400020 [2]重庆市中医院骨科,重庆400020

出　　处：《中华医院感染学杂志》2019年第16期2405-2409,共5页Chinese Journal of Nosocomiology

基　　金：重庆市卫计委医学科研基金资助项目(2015MXSM632)

摘　　要：目的探讨创伤性脓毒症患者血清白细胞介素-35(interleukin-35,IL-35)的表达水平及其与降钙素原(Procalcitonin,PCT)、CD4+CD25+T细胞和预后的关系。方法选择2015年10月-2017年9月重庆市中医院收治的120例创伤患者,按照是否并发脓毒症分为创伤脓毒症组57例和创伤组63例。另外选择同期健康志愿者63名作为对照组。比较三组受试者血清IL-35、PCT和外周血CD4+CD25+T细胞水平,分析创伤性脓毒症患者血清IL-35与PCT和外周血CD4+CD25+T细胞的相关性,同时统计不同转归结果创伤性脓毒症患者血清IL-35水平的变化,另外分析血清IL-35水平对创伤性脓毒症患者生存情况的预测价值。结果创伤脓毒症组患者血清IL-35、PCT、外周血CD4+CD25+T/CD4^+和Tregs%分别为(0.46±0.14)ng/L、(4.73±2.02)μg/L、(1.93±0.62)%、(74.62±8.17)%,高于对照组的(0.13±0.04)ng/L、(0.05±0.02)μg/L、(1.02±0.23)%、(53.14±5.62)%及创伤组的(0.26±0.07)ng/L、(0.19±0.08)μg/L、(1.05±0.45)%、(55.29±6.38)%,且创伤组患者血清IL-35和PCT水平高于对照组,差异均具有统计学意义(P<0.05);创伤脓毒症组血清IL-35水平与PCT、外周血CD4+CD25+T/CD4^+和Tregs%均呈正相关(P<0.05);创伤脓毒症组死亡患者血清IL-35水平高于存活患者(P<0.05);以血清IL-35=0.40ng/L为预测阈值,预测死亡的灵敏度和特异度分别为0.738、0.761,曲线下面积为0.749。结论创伤性脓毒症患者血清IL-35水平异常升高,能够反映机体的炎症及免疫抑制状态,IL-35水平对患者预后结果具有重要指导意义。OBJECTIVE To investigate the expression level of serum interleukin-35(IL-35) in patients with traumatic sepsis and its association with procalcitonin(PCT), CD4+CD25+T cells and prognosis. METHODS Totally 120 cases of trauma patients treated in Chongqing Traditional Chinese Medicine Hospital from Oct. 2015 to Sep. 2017 were selected, and they were divided into traumatic sepsis group(57 cases) and trauma group(63 cases) according to the occurence of concurrent sepsis. Another 63 healthy volunteers in the same period were selected as the control group. The serum levels of IL-35, PCT and peripheral blood CD4+CD25+T cells were compared among the three groups, and the correlations between serum IL-35, PCT and peripheral blood CD4+CD25+T cells in patients with traumatic sepsis were analyzed. At the same time, the changes of serum IL-35 level in patients with traumatic sepsis were analyzed, and the predictive value of serum IL-35 level in the survival of patients with traumatic sepsis was also analyzed. RESULTS The levels of serum IL-35, PCT, peripheral blood CD4+CD25+ T/CD4^+ and Tregs% of traumatic sepsis group were(0.46±0.14) ng/L,(4.73±2.02)μg/L,(1.93±0.62)%,(74.62±8.17)% respectively, significantly higher than(0.13±0.04) ng/L,(0.05±0.02)μg/L,(1.02±0.23)%,(53.14±5.62)% of the control group, and(0.26±0.07) ng/L,(0.19±0.08)μg/L,(1.05±0.45)%,(55.29±6.38)% of the trauma group. The levels of serum IL-35 and PCT of patients in the trauma group were significantly higher than those of the control group(P<0.05). The level of serum IL-35 in the traumatic sepsis group was positively correlated with PCT, CD4+CD25+T/CD4^+ and Tregs% in peripheral blood(P<0.05). The levels of serum IL-35 in the patients with traumatic sepsis who died were significantly higher than those of the surviving patients(P<0.05). Using IL-35=0.40 ng/L as the predicting threshold, the sensitivity, specificity and aear under the curve of predicting death were 0.738, 0.761 and 0.749, respectively. CONCLUSION The serum IL-35 level of patients wi

关 键 词：创伤脓毒症 白细胞介素-35 降钙素原 T淋巴细胞 预后 相关性 

分 类 号：R631.1[医药卫生—外科学]