不同病情分级的脓毒症患者早期血清中细胞因子的变化研究  

Study on the Changes of Cytokines in the Early Serum of Septic Patients with Different Disease Grades

作　　者：程凯 刘钰[1] 刘胜国 潘英[2] 任珊 Cheng Kai;Liu Yu;Liu Shengguo(Shihezi University,Shihezi,Xinjiang,832000,China)

机构地区：[1]新疆石河子大学,新疆石河子832000 [2]新疆石河子大学医学院第一附属医院重症医学一科,新疆石河子832000

出　　处：《黑龙江医学》2024年第3期261-263,267,共4页Heilongjiang Medical Journal

基　　金：国家自然科学基金(81801957)。

摘　　要：目的:探究不同病情分级的脓毒症患者早期血清中肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白介素-4(IL-4)及白介素-10(IL-10)含量变化规律及意义。方法:选取2021年10月—2022年10月新疆石河子大学医学院第一附属医院ICU收治的47例脓毒症患者作为研究对象,按急性生理和慢性健康评分(APACHEⅡ)将患者分为APACHEⅡ≤15分组14例、15分<APACHEⅡ≤25分组15例和APACHEⅡ>25分组18例。分别在确诊时、确诊后6 h、12 h、24 h、48 h、72 h采血,并选取医院同期收治的15例非脓毒症患者作为对照组,细胞因子检测采用酶联免疫吸附法。结果:APACHEⅡ≤15分组TNF-α、IFN-γ与对照组比较,差异有统计学意义(P<0.05),其峰值均在确诊后48 h。15分<APACHEⅡ≤25分组TNF-α、IFN-γ、IL-10、IL-4与对照组比较,差异有统计学意义(P<0.05),TNF-α、IFN-γ、IL-10均高于APACHEⅡ≤15分组,差异有统计学意义(P<0.05),TNF-α和IFN-γ的峰值在确诊后24 h。APACHEⅡ>25分组TNF-α、IFN-γ、IL-10、IL-4水平高于15分<APACHEⅡ≤25分组、APACHEⅡ≤15分组及对照组,差异有统计学意义(P<0.05),其TNF-α、IFN-γ的峰值分别在确诊后12 h和24 h。IL-10和IL-4在各组中都呈逐渐上升趋势。结论:脓毒症患者血清中细胞因子含量越高,说明病情越重。不同病情分级的患者细胞因子的动态变化趋势不同,所处的免疫状态也不同,故早期监测细胞因子的动态趋势,对脓毒症患者的治疗具有积极意义。Objective:To investigate the changing rules and significance of tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-4(IL-4)and interleukin-10(IL-10)levels in early serum of patients with sepsis with different disease grades.Methods:47 patients with sepsis admitted to the hospital from October 2021 to October 2022 were selected as the study subjects,and the patients were categorized into 14 cases in the group of APACHEⅡ≤15,15 cases in the group of 15<APACHEⅡ≤25,and 18 cases in the group of APACHEⅡ>25 according to the APACHEⅡscore.Blood was collected at the time of diagnosis,6 h,12 h,24 h,48 h,and 72 h after diagnosis,respectively,and 15 non-sepsis patients admitted to the hospital during the same period were selected as the control group,and cytokines were detected by enzyme-linked immunosorbent assay.Results:The difference between TNF-αand IFN-γin the APACHEⅡ≤15 subgroup and the control group was statistically significant(P<0.05),and their peaks were all at 48 h after diagnosis.The differences of TNF-α,IFN-γ,IL-10,and IL-4 in the group with 15 points<APACHEⅡ≤25 points compared with the control group were statistically significant(P<0.05).TNF-α,IFN-γ,and IL-10 were higher than those in the group with APACHEⅡ≤15 points,and the differences were statistically significant(P<0.05).TNF-αand IFN-γpeaked 24 h after diagnosis.The levels of TNF-α,IFN-γ,IL-10,and IL-4 were higher in the group with APACHEⅡ>25 points than in the group with 15<APACHEⅡ≤25 points,the group with APACHEⅡ≤15 points,and the control group,and the difference was statistically significant(P<0.05).The peaks of TNF-αand IFN-γwere at 12 h and 24 h after diagnosis,respectively.IL-10 and IL-4 showed a gradual increase in all groups.Conclusion:Patients with sepsis have higher cytokine levels in the serum,indicating a more severe condition.The dynamic trend of cytokines in patients with different disease grades is different,and the immune status they are in is also different,so early monitoring of th

关 键 词：脓毒症 肿瘤坏死因子-α 干扰素-Γ 白介素-10 白介素-4 免疫状态 

分 类 号：R459.7[医药卫生—急诊医学]