新生儿感染性肺炎IL-6/STAT3信号通路表达水平与病情和预后的关系  

Correlation between expression level of IL-6/STAT3 signaling pathway and illness condition and prognosis

作　　者：史丽峰[1] 杨祎[1] 朱娟[1] 潘云凤[1] 陈惠萍[1] SHI Li-feng;YANG Yi;ZHU Juan;PAN Yun-feng;CHEN Hui-ping(Liyang People's Hospital,Liyang,Jiangsu 213300,China)

机构地区：[1]溧阳市人民医院新生儿科,江苏溧阳213300

出　　处：《中华医院感染学杂志》2021年第12期1796-1801,共6页Chinese Journal of Nosocomiology

基　　金：江苏省科研基金资助项目(2019GH241111)。

摘　　要：目的探究新生儿感染性肺炎外周血白细胞介素-6(IL-6)/信号转导和转录激活子3(STAT3)信号通路表达水平与疾病严重程度和预后的相关性。方法选择2018年3月-2020年3月溧阳市人民医院收治的76例感染性肺炎患儿设为肺炎组以及同期收治的70例非感染性肺炎患儿设为对照组。所有研究参与者均测定外周血辅助性T细胞17(Th17)和调节性T细胞(Treg),血清IL-6、IL-17A、转化生长因子β(TGF-β),STAT3 mRNA表达水平,分析其在患儿病情严重程度以及预后的临床意义。结果肺炎组患儿Th17细胞、Th17/Treg、IL-6、IL-17A、STAT3 mRNA表达高于对照组,而Treg细胞、TGF-β1低于对照组(P<0.001);IL-6、STAT3 mRNA表达与Th17细胞、Th17/Treg、IL-17A呈正相关(P<0.05),与Treg细胞、TGF-β1呈负相关(P<0.05);重症组患儿Th17细胞、Th17/Treg、IL-6、IL-17A、STAT3 mRNA表达高于轻症组,而Treg细胞、TGF-β1低于轻症组(P<0.05);病情严重程度与Th17细胞、Th17/Treg、IL-6、IL-17A、STAT3 mRNA表达呈正相关(r=0.516,0.622,0.457,0.722,0.803;P均<0.05),与Treg细胞、TGF-β1呈负相关(r=-0.509,-0.683;P均<0.05);预后良好组患儿Th17细胞、Th17/Treg、IL-6、IL-17A、STAT3 mRNA表达低于预后不良组,而Treg细胞、TGF-β1高于预后不良组(P<0.05);Th17细胞、Treg细胞、Th17/Treg、IL-6、IL-17A、TGF-β1水平、STAT3 mRNA表达用于预测患儿预后曲线下面积(AUC)分别为0.843、0.778、0.862、0.841、0.836、0.673、0.762。结论感染性肺炎新生儿IL-6/STAT3信号通路异常激活,因其所致Th17/Treg细胞失衡可能是病情发生、进展的重要原因,用于评估患儿预后有一定价值。OBJECTIVE To explore the correlation between the expression level of peripheral blood interleukin-6(IL-6)/signal transducer and activator of transcription 3(STAT3)signaling pathway and severity and prognosis of neonatal infectious pneumonia.METHODS Between Mar.2018 and Mar.2020,76 neonates with infectious pneumonia and 70 neonates with non-infectious pneumonia admitted to Liyang People’s Hospital were enrolled and divided into the pneumonia group and control group.The expression levels of peripheral blood T helper 17 cells(Th17)and regulatory T cells(Treg),serum IL-6,IL-17 A,transforming growth factor beta 1(TGF-β1)and STAT3 mRNA in all objects were detected.The clinical significance of above indexes in the severity and prognosis evaluation was analyzed.RESULTS The expressions levels of Th17,Th17/Treg,IL-6,IL-17 A and STAT3 mRNA in the pneumonia group were significantly higher than those in the control group,while Treg cells and TGF-β1 were significantly lower than those in the control group(P<0.05).IL-6 and STAT3 mRNA were positively correlated with Th17,Th17/Treg and IL-17 A(P<0.05),but were negatively correlated with Treg and TGF-β1(P<0.05).The expression levels of Th17,Th17/Treg,IL-6,IL-17 A and STAT3 mRNA in the severe group were significantly higher than those in the mild group,while Treg and TGF-β1 were significantly lower than those in the mild group(P<0.05).The severity of disease was positively correlated with the expression levels of Th17,Th17/Treg,IL-6,IL-17 A and STAT3 mRNA(r=0.516,0.622,0.457,0.722,0.803,P<0.05),but was negatively correlated with Treg and TGF-β1(r=-0.509,-0.683,P<0.05).The expression levels of Th17,Th17/Treg,IL-6,IL-17 A and STAT3 mRNA in the good prognosis group were significantly lower than those in the poor prognosis group,while Treg and TGF-β1 were significantly higher than those in the poor prognosis group(P<0.05).AUC values of Th17,Treg,Th17/Treg,IL-6,IL-17 A,TGF-βand STAT3 mRNA for predicting prognosis were 0.843,0.778,0.862,0.841,0.836,0.673,and 0.762,respectively.C

关 键 词：新生儿感染性肺炎 白细胞介素-6/信号转导和转录激活子3信号通路 病情 预后 评估价值 

分 类 号：R563.1[医药卫生—呼吸系统]