脑卒中介入溶栓术后肺部感染IL-33/ST-2通路改变及IL-33多态性  

Variation of IL-33/ST-2 pathway and analysis of IL-33 polymorphism in pulmonary infection patients after interventional thrombolytic surgery for stroke

作　　者：巩建梅 丁健 侯鹏 张秀芳 宋小芸 孙滨 GONG Jian-mei;DING Jian;HOU Peng;ZHANG Xiu-fang;SONG Xiao yun;SUN Bin(Laboratory of Qingdao Huici Medical Group,Qingdao,Shandong 266000,China)

机构地区：[1]山东省青岛市海慈医疗集团检验科,山东青岛266000

出　　处：《中华医院感染学杂志》2021年第7期972-975,共4页Chinese Journal of Nosocomiology

基　　金：山东省科研基金资助项目(2018349)。

摘　　要：目的探讨脑卒中介入溶栓术后肺部感染患者白介素-33(IL-33)/特异性受体肿瘤发生抑制蛋白2(ST2)通路改变及IL-33多态性与疾病易感性的关系。方法选择青岛市海慈医疗集团神经内科2019年1月-2020年1月收治脑卒中患者中住院期间肺部感染患者80例作为感染组,选择同期进行治疗的脑卒中非合并肺部感染患者40例作为非感染组。采用酶联免疫吸附法(ELISA)检测其血清中IL-33、ST2及干扰素-γ(IFN-γ)、白介素-4(IL-4)、白介素-17(IL-17)、转化生长因子-β(TGF-β)水平;采用受试者工作特征曲线(ROC)评价IL-33、ST2对肺部感染诊断价值;采用聚合酶链反应限制性片段长度多态性(PCR-RFLP)检测IL-33基因rs7025417多态性进行分析。结果感染组血清IL-33、ST-2、IL-17、TGF-β、IFN-γ、IL-4水平高于非感染组(P<0.05);ROC分析结果显示血清IL-33、ST2对于脑卒中患者肺部感染的诊断曲线下面积分别为0.797和0.812;IL-33敏感度为78.00%,特异度为74.00%,95%CI值0.711~0.882,ST2敏感度90.00%,特异度60.00%,95%CI值为0.731~0.894;两组C、T等位基因分布差异具有统计学意义(χ^(2)=4.812,P=0.028);经Logistic回归分析校正混杂因素后,IL-33基因rs7025417位点携带TT基因型及T等位基因肺部感染发病风险分别为CC基因型及C基因的1.971倍和1.618倍。结论血清IL-33、ST2水平对于脑卒中患者住院发生肺部感染有一定的诊断价值,IL-33基因rs7025417位点多态性与肺部感染易感性有关,T等位基因可能为易感基因。OBJECTIVE To explore the change of interleukin-33(IL-33)/specific receptor tumorigenicity 2(ST2) pathway and the correlation between IL-33 polymorphism and the disease susceptibility in patients with lung infection after interventional thrombolysis of stroke. METHODS All 80 patients with lung infection during hospitalization in the Department of Neurology of Qingdao Heci Medical Group from Jan. 2019 to Jan. 2020 were enrolled as the infection group;another 40 patients with stroke but without lung infection during the same period were recruited as the non-infected group. The enzyme-linked immunosorbent assay(ELISA) was used to detect levels of IL-33, ST2, interferon-γ(IFN-γ), interleukin-4(IL-4), interleukin-17(IL-17) and transforming growth factor-β(TGF-β);receiver operating characteristic curves(ROCs) were used to evaluate the value of IL-33 and ST2 levels in the diagnosis of lung infection;polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP) was used to detect the polymorphism of IL-33 gene rs7025417. RESULTS The levels of serum IL-33, ST-2, IL-17, TGF-β, IFN-γ and IL-4 in the infected group were significantly higher than that in the non-infected group(P<0.05). ROC analysis showed that the AUCs of the serum IL-33 and ST2 were 0.797 and 0.812 respectively;the sensitivity of IL-33 was 78.00%, with the specificity of 74.00% and 95%CI value of 0.711-0.882;the sensitivity of ST2 was 90.00%, its specificity was 60.00% and 95%CI value was 0.731-0.894. The difference of the distribution of C and T alleles between the two groups was significant(χ^(2)=4.812, P=0.028). After correction of confounding factors by Logistic regression analysis, the risk of genetic lung infection in patients carrying TT genotype and T allele at the rs7025417 locus of IL-33 were 1.971 times and 1.618 times higher than that carrying CC genotype and C allele, respectively. CONCLUSION Serum IL-33 and ST2 levels have certain diagnostic value for stroke patients combined with lung infection. The polymorphism of IL-33 g

关 键 词：脑卒中 肺部感染 白介素-33 特异性受体肿瘤发生抑制蛋白2 多态性分析 

分 类 号：R563.1[医药卫生—呼吸系统]