ARDS患者外周血及肺泡灌洗液中TGF-β/IL-17平衡变化及临床意义分析  

Analysis of the changes and clinical significance of TGF-β/IL-17 balance in peripheral blood and bronchoalveolar lavage fluid of ARDS patients

作　　者：李茜[1] 屠越兴[2] 朱蔚[1] 胡秀平[2] 江玲芝[2] LI Qian;TU Yuexing;ZHU Wei;HU Xiuping;JIANG Lingzhi(Department of Emergency Medicine,Zhejiang Provincial People′s Hospital,People′s Hospital of Hangzhou Medical College,Hangzhou310014,China;Department of Intensive Care Medicine,Zhejiang Provincial People′s Hospital,People′s Hospital of Hangzhou Medical College,Hangzhou310014,China)

机构地区：[1]浙江省人民医院杭州医学院附属人民医院急诊医学科,浙江杭州310014 [2]浙江省人民医院杭州医学院附属人民医院重症医学科,浙江杭州310014

出　　处：《中国现代医生》2022年第2期1-4,19,共5页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2021ZB019)。

摘　　要：目的探讨急性呼吸窘迫综合征(ARDS)患者外周血及肺泡灌洗液(BALF)中细胞因子及TGF-β/IL-17平衡变化并分析其临床意义。方法选择浙江省人民医院重症医学科2015年1月至2019年10月收治的50例ARDS患者(ARDS组)及30例急性心力衰竭患者(对照组)为研究对象,将ARDS组根据住院28 d结局分为生存组和死亡组。采用酶联免疫吸附法(ELISA)测定所有患者外周血及BALF中IL-6、IL-10、IL-17和TGF-β水平,比较ARDS组与对照组及不同结局ARDS患者间外周血及BALF中IL-6、IL-10、IL-17和TGF-β水平及TGF-β/IL-17差异。结果ARDS组外周血中IL-6、IL-10、IL-17、TGF-β水平均明显高于对照组,且TGF-β/IL-17水平明显降低,差异均有统计学意义(P<0.001)。ARDS组BALF中IL-6、IL-10、IL-17、TGF-β水平均明显高于对照组,且TGF-β/IL-17水平明显降低,差异均有统计学意义(P<0.001)。死亡组外周血中IL-6、IL-10、IL-17、TGF-β水平均明显高于生存组,且TGF-β/IL-17水平明显降低,差异均有统计学意义(P<0.001)。死亡组BALF中IL-6、IL-10、IL-17、TGF-β水平均明显高于生存组,且TGF-β/IL-17水平明显降低,差异均有统计学意义(P<0.001)。结论ARDS患者外周血及肺泡灌洗液中IL-17和TGF-β水平明显升高,TGF-β/IL-17水平明显下降,提示ARDS患者存在免疫失衡,有助于判断病情及调节免疫治疗。Objective To investigate the changes of cytokines and TGF-β/IL-17 balance in peripheral blood and bronchoalveolar lavage fluid(BALF)of patients with acute respiratory distress syndrome(ARDS)and analyze their clinical significance.Methods A total of 50 patients with ARDS(ARDS group)and 30 patients with acute heart failure(control group)admitted to the Department of Intensive Care of Zhejiang Provincial People′s Hospital from January 2015 to October 2019 were selected as the study subjects.The ARDS group was divided into survival group and death group according to the 28-day outcome of hospitalization.Enzyme-linked immunosorbent assay(ELISA)was used to determine the levels of IL-6,IL-10,IL-17 and TGF-βin peripheral blood and BALF of all patients.The levels of IL-6,IL-10,IL-17 and TGF-βand the difference of TGF-β/IL-17 in peripheral blood and BALF between the ARDS group and the control group and ARDS patients with different outcomes were compared.Results The levels of IL-6,IL-10,IL-17 and TGF-βin peripheral blood of the ARDS group were significantly higher than those of the control group,and TGF-β/IL-17 was significantly lower.The differences were statistically significant(P<0.001).The levels of IL-6,IL-10,IL-17,and TGF-βin BALF of the ARDS group were significantly higher than those of the control group,and TGF-β/IL-17 levels were significantly lower,and the differences were statistically significant(P<0.001).The levels of IL-6,IL-10,IL-17,and TGF-βin the peripheral blood of the death group were significantly higher than those of the survival group,and TGF-β/IL-17 levels were significantly lower,and the differences were statistically significant(P<0.001).The levels of IL-6,IL-10,IL-17,and TGF-βin BALF of the death group were significantly higher than those of the survival group,and TGF-β/IL-17 levels were significantly lower,and the differences were statistically significant(P<0.001).Conclusion The levels of IL-17 and TGF-βin peripheral blood and bronchoalveolar lavage fluid of ARDS patients are signi

关 键 词：急性呼吸窘迫综合征 IL-17 TGF-Β 免疫失衡 

分 类 号：R563.9[医药卫生—呼吸系统]