肾综合征出血热患者血清炎性细胞因子与疾病进程及预后的相关性  

Correlation of serum inflammatory cytokines with disease progression and prognosis in patients with hemorrhagic fever with renal syndrome

作　　者：尤佳[1] 陈月 YOU Jia;CHEN Yue(Jinzhou Center for Disease Control and Prevention,Jinzhou 121000,China;The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China)

机构地区：[1]锦州市疾病预防控制中心,辽宁锦州121000 [2]锦州医科大学附属第一医院,辽宁锦州121000

出　　处：《中华卫生杀虫药械》2021年第1期62-66,共5页Chinese Journal of Hygienic Insecticides and Equipments

基　　金：国家科技重大专项资助项目(编号:2017ZX10103007-001)。

摘　　要：目的分析肾综合征出血热患者不同临床分期及不同临床分型血清中C反应蛋白、白细胞介素-1、白细胞介素-6、肿瘤坏死因子-α水平与疾病的相关性,为HFRS临床诊治提供依据。方法以2018年6月至2020年1月在锦州医科大学附属第一医院住院的37例HFRS患者和15例健康体检者(对照组)为研究对象,用ELISA法分别检测患者血清炎性细胞因子CRP、IL-1、IL-6和TNF-α水平,并分析其与临床分期、临床分型的相关性。结果临床分期为急性期和恢复期的患者血清中CRP、IL-1、IL-6和TNF-α水平均高于正常组(P<0.01),且急性期各细胞因子显著高于恢复期(P<0.01);临床分型轻型、中型、重型、危重型患者血清CRP、IL-1、IL-6和TNF-α水平较比对照组有不同程度的增加(P<0.05)。Spearman相关分析显示,CRP、IL-1、IL-6和TNF-α水平与不同临床分期呈负相关(r=-0.48,P<0.01;r=-0.59,P<0.01;r=-0.33,P=0.03;r=-0.47,P<0.01);与不同临床分型呈正相关(r=0.42,P=0.01;r=0.56,P<0.01;r=0.52,P<0.01;r=0.34,P=0.04);与预后(存活)呈负相关(r=-0.32,P=0.02;r=-0.46,P<0.01;r=-0.40,P<0.01;r=-0.37,P=0.01)。结论HFRS患者血清炎性细胞因子水平与疾病严重程度及预后密切相关。Objective To analyze the correlation among serum levels of C-reactive protein(CRP),interleukin-1(IL-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and the disease in patients with Hemorrhagic fever with renal syndrome(HFRS)in different clinical phases and different clinical classifications,and provide reference for clinical diagnosis and treatment of HFRS.Methods A total of 37 HFRS patients hospitalized in the First Affiliated Hospital of Jinzhou Medical University from June 2018 to January 2020,and 15 healthy medical examinees(control group)were used as research subjects.The serum inflammatory cytokine of CRP,IL-1,IL-6 and TNF-αlevels were detected by ELISA,and then analyze their correlation with different clinical phases and clinical classifications.Results Compared with the control group,the levels of CRP,IL-1,IL-6 and TNF-αin clinical phases of acute and recovery were significantly increased(P<0.01),and the cytokines in acute phase were higher than those in recovery phase(P<0.01).The serum levels of CRP,IL-1,IL-6 and TNF-αin clinical classifications of light,medium,heavy,critical type were higher than those in the control group(P<0.05).Spearman correlation analysis showed that levels of CRP,IL-1,IL-6 and TNF-αwere negatively correlated with different clinical phases(r=-0.48,P<0.01;r=-0.59,P<0.01;r=-0.33,P=0.03;r=-0.47,P<0.01),positively correlated with different classifications(r=0.42,P=0.01;r=0.56,P<0.01;r=0.52,P<0.01;r=0.34,P=0.04),and negatively correlated with prognosis(survival)(r=-0.32,P=0.02;r=-0.46,P<0.01;r=-0.40,P<0.01;r=-0.37,P=0.01).Conclusion The serum levels of inflammatory cytokines are closely related to the severity of the disease in HFRS patients.

关 键 词：肾综合征出血热 临床分期 临床分型 预后 CRP IL-1 IL-6 TNF-α 

分 类 号：R183.5[医药卫生—流行病学]