外周血T淋巴细胞亚群与炎症细胞因子在鉴别鲍氏不动杆菌感染中的作用  

Role of peripheral blood T lymphocyte subsets and inflammatory cytokines in the identification of pan-drug resistant Acinetobacter baumannii infection

作　　者：李静[1] 许东风[2] 张静[3] 赵登峰[2] 徐慧[4] 丁锋[2] 靳莉莉[5] LI Jing;XU Dong-feng;ZHANG Jing;ZHAO Deng-feng;XU Hui;DING Feng;JIN Li-li(The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473058,China;不详)

机构地区：[1]南阳医学高等专科学校第一附属医院呼吸与危重症监护室,河南南阳473058 [2]南阳医学高等专科学校第一附属医院呼吸与危重症医学科,河南南阳473058 [3]南阳医学高等专科学校第一附属医院检验科,河南南阳473058 [4]南阳医学高等专科学校第一附属医院感染管理科,河南南阳473058 [5]商丘医学高等专科学校护理系,河南商丘476100

出　　处：《中华医院感染学杂志》2022年第12期1776-1779,共4页Chinese Journal of Nosocomiology

基　　金：商丘市科技计划基金资助项目(153053)。

摘　　要：目的分析外周血T淋巴细胞亚群与炎症细胞相关因子在鉴别鲍氏不动杆菌感染中的诊断价值。方法选取2018年7月-2020年6月南阳医学高等专科学校第一附属医院住院并确诊为鲍氏不动杆菌感染的肺炎患者设为研究组(n=21),并选取同时期非鲍氏不动杆菌感染的肺炎患者设为对照组(n=79)。检测两组患者T淋巴细胞亚群(CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+))和γ-干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-17(IL-17)。Spearman相关分析鲍氏不动杆菌感染与上述指标的相关性,并绘制受试者工作特征(ROC)曲线比较各检测指标对鲍氏不动杆菌感染的鉴别诊断效能。结果两组患者CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、TNF-α、IFN-γ、IL-2、IL-17水平比较,差异有统计学意义(P<0.05)。Spearman相关分析显示,鲍氏不动杆菌感染和TNF-α、IFN-γ、IL-2、IL-17呈正相关(P<0.05),与CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)呈负相关(P<0.05)。ROC显示,鲍氏不动杆菌感染诊断的约登指数由高至低依次为IL-17、IFN-γ、CD_(4)^(+)/CD_(8)^(+),且IL-17的敏感度和特异度最高。结论血清IL-17、IFN-γ、CD_(4)^(+)/CD_(8)^(+)均与鲍氏不动杆菌感染存在相关性,且均对鲍氏不动杆菌定植与感染具有一定的鉴别诊断价值,尤其是IL-17,可为临床诊断提供依据。OBJECTIVE To analyze the diagnostic value of peripheral blood T lymphocyte subsets and inflammatory cell-related factors in the identification of Acinetobacter baumannii infection.METHODS Patients with pneumonia who were hospitalized and diagnosed with A.baumannii infection in The First Affiliated Hospital of Nanyang Medical College from Jul.2018 to Jun.2020 were enrolled as the observation group(n=21),and 79 non-Baumannii patients without A.baumannii infection during the same period were in the control group.The T lymphocyte subsets(CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)),γ-interferon(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-2(IL-2)and interleukin-17(IL-17)were detected in the two groups of patients.Spearman correlation analysis was performed to analyze the correlation between A.baumannii infection and the above indicators,and the receiver operating characteristic(ROC)curve was drawn to compare the diagnostic efficiency of each detection index for A.baumannii infection.RESULTS There were significant differences in the levels of serum CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),TNF-α,IFN-γ,IL-2 and IL-17 between the two groups(P<0.05).Spearman correlation analysis showed that A.baumannii infection was positively correlated with TNF-α,IFN-γ,IL-2 and IL-17 levels(P<0.05),while was negatively correlated with CD_(3)^(+),CD_(4)^(+)cell counts and CD_(4)^(+)/CD_(8)^(+)ratio(P<0.05).Multivariate Logistic regression analysis showed that IFN-γand IL-17 levels were independent risk factors for A.baumannii infection(P<0.05),and CD_(4)^(+)/CD_(8)^(+)ratio were protective factors for A.baumannii infection(P<0.05).ROC showed that the Youden index of IL-17,IFN-γand CD_(4)^(+)/CD_(8)^(+)ratio for the diagnosis of A.baumannii infection was descending,and IL-17 had the highest sensitivity and specificity.CONCLUSION Serum IL-17 and IFN-γlevels and CD_(4)^(+)/CD_(8)^(+)ratio are significantly correlated with A.baumannii infection,which all have certain differential diagnosis value for A.baumannii colonization and infec

关 键 词：T淋巴细胞亚群 炎症细胞因子 鲍氏不动杆菌 呼吸内科 感染 

分 类 号：R378[医药卫生—病原生物学]