脓毒症患者外周血激活蛋白-1白细胞介素-17表达水平及其临床意义  

The expression levels and their clinical significance of AP-1 and IL-17 in peripheral blood of patients with sepsis

作　　者：张永利[1] 张莉 杨焕霞[1] Zhang Yongli;Zhang Li;Yang Huanxia(Intensive Care Medicine Department,Baoji Central Hospital,Shaanxi 721008,China;不详)

机构地区：[1]陕西省宝鸡市中心医院重症医学科,721008 [2]陕西省宝鸡市太白县医院儿科

出　　处：《山西医药杂志》2023年第18期1372-1376,共5页Shanxi Medical Journal

摘　　要：目的探讨激活蛋白1(AP-1)、白细胞介素-17(IL-17)在脓毒症休克及严重脓毒症患者中的表达水平及临床意义。方法分析本院114例脓毒症休克患者(脓毒症休克组)和10^(9)例不伴休克的脓毒症患者(脓毒症组)临床资料,并根据住院期间是否死亡将其分为死亡组42例和生存组181例。用实时荧光定量PCR(q RT-PCR)法检测血清AP-1 mRNA表达水平,酶联免疫吸附法(ELISA)检测血清IL-17及实验室指标C反应蛋白(CRP)水平,电化学发光免疫分析仪检测降钙素原水平,血细胞分析仪检测外周血白细胞计数;脓毒症休克患者血清AP-1 mRNA、IL-17与实验室指标的相关性用Pearson法分析;血清AP-1、IL-17水平对脓毒症患者死亡的预测价值用受试者工作特征(ROC)曲线分析。结果脓毒症休克组白细胞计数[(15.7±3.9)×10^(9)/L]、降钙素原[(13.2±3.1)ng/ml]、CRP[(30.8±5.2)mg/L]高于严重脓毒症组(11.6±3.6)×10^(9)/L、(8.2±2.3)ng/ml、(17.6±3.8)mg/L],差异有统计学意义(P<0.05)。脓毒症休克组血清AP-1 mRNA(2.45±0.36)、IL-17[(92.2±8.0)μg/L]高于严重脓毒症组[(1.02±0.23)、(72.8±9.7)μg/L,差异有统计学意义(P<0.05)。脓毒症休克患者血清AP-1 mRNA与IL-17呈正相关(r=0.54,P<0.05),且二者与白细胞计数、降钙素原、CRP呈正相关(P<0.05)。死亡组血清AP-1 mRNA(2.85±0.59)、IL-17[(95.3±9.1)μg/L]水平高于生存组[(1.87±0.43)、(80.3±8.8)μg/L],差异有统计学意义(P<0.05)。AP-1 mRNA、IL-17联合预测脓毒症患者死亡的曲线下面积(AUC)为0.943(95%CI:0.904,0.983),特异度为95.0%,灵敏度为83.3%。结论血清AP-1 mRNA、IL-17水平变化与脓毒症患者病情程度相关,且对预后有重要预测价值。Objective To investigate the expression levels and clinical significance of activator protein-1(AP-1)and interleukin-17(IL-17)in patients with septic shock and severe sepsis.Methods The clinical data of 114 patients with septic shock(septic shock group)and 10^(9)patients with severe sepsis without shock(severe sepsis group)in our hospital were analyzed,and according to whether they died during hospitalization,they were divided into 42 cases in death group and 181 cases in survival group.Real-time fluorescent quantitative PCR(qRT-PCR)method was used to detect the expression level of serum AP-1 mRNA,enzyme-linked immunosorbent(ELISA)method was used to detect the levels of serum IL-17 and laboratory index C-reactive protein(CRP),electrochemiluminescence immunoassay analyzer was used to detect the level of procalcitonin,hematology analyzer was used to detect peripheral blood white blood cell count.Pearson method was used to analyze the correlation between serum AP-1 mRNA and IL-17 and laboratory indicators in patients with septic shock.Receiver operating characteristic(ROC curve)was used to analyze the predictive value of serum AP-1 and IL-17 levels for the death of patients with sepsis.Results The white blood cell count[(15.7±3.9)×10^(9)/L],procalcitonin[(13.2±3.1)ng/ml],and CRP[(30.8±5.2)mg/L]in the septic shock group were higher than those in the severe sepsis group[(11.6±3.6)×10^(9)/L,(8.2±2.3)ng/ml,(17.6±3.8)mg/L],and the difference was statistically significant(P<0.05).The serum AP-1 mRNA(2.45±0.36)and IL-17[(92.2±8.0)μg/L]in the septic shock group were higher than those in the severe sepsis group[(1.02±0.23),(72.8±9.7)μg/L],and the difference was statistically significant(P<0.05).Serum AP-1 mRNA and IL-17 in patients with septic shock were positively correlated(r=0.54,P<0.05),and the two were positively correlated with white blood cell count,procalcitonin and CRP(P<0.05).The levels of serum AP-1 mRNA(2.85±0.59)and IL-17[(95.3±9.1)μg/L]in the death group were higher than those in the survival g

关 键 词：脓毒症 激活蛋白1 白细胞介素-17 预后 

分 类 号：R459.7[医药卫生—急诊医学]