血清IL-6与中性粒细胞表型及吞噬力关系在脓毒症分期中的诊断价值  

The diagnostic value of serum interleukin-6 in relation to neutrophil phenotypes and phagocytosis in clinical staging of patients with sepsis

作　　者：董晓玉[1,2] 马晴晴 殷俊[4] 李家斌[4] 郑美娟[1,3] 沈继龙[1,3] Dong Xiaoyu;Ma Qingqing;Yin Jun(Dept of Microbiology and Parasitology,the Key Laboratory of Pathogen Biology Anhui(Anhui Medical University),Heifei 230032;Clinical Laboratory of Chaohu Hospital,Anhui Medical University,Chaohu 238000;Dept of Clinical Laboratory,The First Affiliated Hospital of Anhui Medical University,Heifei 230022;Dept of Infectious Diseases,The First Affiliated Hospital of Anhui Medical University,Heifei 230022)

机构地区：[1]安徽医科大学病原生物学教研室、安徽省病原生物学重点实验室、安徽高校人兽共患病重点实验室,合肥230032 [2]安徽医科大学附属巢湖医院检验科,巢湖238000 [3]安徽医科大学第一附属医院检验科,合肥230022 [4]安徽医科大学第一附属医院感染科,合肥230022

出　　处：《安徽医科大学学报》2020年第8期1265-1270,共6页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81973983)。

摘　　要：目的探讨血清白细胞介素6(IL-6)水平与中性粒细胞表型及吞噬力关系在脓毒症分期中的诊断价值。方法选取患者121例,分为两组:全身炎症反应综合征(SIRS)患者(95例,包括非脓毒症患者19例,脓毒症患者56例,脓毒症休克患者20例)、局部感染组(26例)以及20例健康者为对照组。检测患者血清细胞因子IL-2、IL-4、IL-6、IL-10、干扰素(IFN)-γ、肿瘤坏死因子(TNF)-α、降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)水平及白细胞(WBC)计数;及外周血中性粒细胞(PBNs)表面簇分化抗原(CD)62L、CD64和CD11b分子及其吞噬功能。结果SIRS组患者血清IL-6和IL-10水平最高(P<0.01),其次为局部感染组和正常对照组(P<0.01)。脓毒症休克组IL-6水平最高(P<0.01),其次为脓毒症组和非脓毒症组(P<0.01)。脓毒症休克组与脓毒症组血清IL-10水平比较差异无统计学意义(P>0.05)。与低IL-6组比较,高IL-6组脓毒症患者血清hsCRP、PCT和IL-10水平亦见增高(P<0.01),PBNs CD11b指数和CD64指数也同时增高(P<0.01),高IL-6组患者中性粒细胞吞噬功能高于低IL-6组(P<0.01)。结论脓毒症患者的血清IL-6水平随着疾病进展而逐渐升高,脓毒症休克患者的血清IL-6水平最高,其次是脓毒症和非脓毒症患者。高IL-6水平脓毒症患者中性粒细胞吞噬作用增强,同时高表达CD64和CD11b。血清IL-6水平与脓毒症的诊断和分期密切相关,动态监测脓毒症患者血清IL-6可为临床诊断及分期、疾病进展提供参考依据,值得在临床推广。Objective To study the serum interleukin-6 concentration and phenotypes and phagocytosis of neutrophils for the diagnosis and staging of sepsis.Methods A total of 121 patients were collected between January 2018 and June 2019.The patients were divided into two groups:the group of systemic inflammatory response syndrome(SIRS,95 cases,including 19 cases of non-sepsis,56 cases of sepsis and 20 cases of septic shock),the group of local infection(26 cases).Meanwhile,20 cases of healthy volunteers were selected as the control group.Cytokines(IL-2,IL-4,IL-6,IL-10,IFN-γ,TNF-α),PCT,hsCRP,and WBC counts were measured,and the phenotypes(CD64,CD11 b and CD62 L)of peripheral blood neutrophils(PBNs)and their phagocytic function were determined.Results The levels of serum IL-6 and IL-10 were found to be highest in the patients of SIRS group(P<0.01),followed by those of the local infection group and the control(P<0.01).The patients of septic shock had the highest level of serum IL-6(P<0.01),followed by those of septic group and non-septic group(P<0.01),but no significant difference of IL-10 levels was noted between the groups of septic shock and sepsis(P>0.05).Compared with those of low IL-6 concentration in the groups,patients with high serum IL-6 level simultaneously presented elevated levels of hs-CRP,PCT and IL-10(P<0.01),accompanied by increased expressions of CD11 b and CD64(P<0.01).Additionally,the PBNs phagocytosis was found to be enhanced in the patients of high IL-6 level when compared with those of low IL-6 level(P<0.01).Conclusion The serum level of IL-6 in the patients with sepsis gradually increased as the disease progresses,and the highest level of serum IL-6 may be noted in the patients with sepsis shock,followed by those of sepsis and non-sepsis consecutively.An elevated level of serum IL-6 was frequently accompanied by enhanced neutrophil phagocytosis and high expressions of CD64 and CD11 b in the patients with sepsis.Taken together,examination of serum IL-6,which is closely associated with clinical stages of

关 键 词：IL-6 IL-10 CD64 CD11B CD62L 脓毒症 

分 类 号：R631.3[医药卫生—外科学]