肺部感染并发脓毒症患者血清PD-L1、LAG-3与炎症因子的表达及临床意义  

Expression and clinical significance of PD-L1,LAG-3,and inflammatory factors in the serum of patients with pulmonary infection complicated by sepsis

作　　者：吕志文 万鲁云 李鹏程[2] Lyu Zhiwen;Wan Luyun;Li Pengcheng(Department of Clinical Laboratory,Honghu Hospital of Traditional Chinese Medicine,Jingzhou 433202,China)

机构地区：[1]洪湖市中医医院检验科,荆州433202 [2]华中科技大学同济医学院附属协和医院肿瘤中心

出　　处：《中华保健医学杂志》2024年第3期290-294,共5页Chinese Journal of Health Care and Medicine

基　　金：湖北省自然科学基金(2020HBA216)。

摘　　要：目的 探讨肺部感染并发脓毒症患者血清中程序性死亡受体配体1(PD-L1)、淋巴细胞激活基因3(LAG-3)与炎症因子的表达水平及临床意义。方法 回顾性选取2021年6月~2023年7月洪湖市中医医院收治的96例肺部感染并发脓毒症患者为观察组,根据其预后生存情况分为生存组68例、死亡组28例,以同期体检的110名健康人员为健康对照组。观察两组受检者在入院第1、3、5和7天查血清PD-L1、LAG-3,白细胞介素(IL)-6、IL-8、IL-10、降钙素原(PCT)、C反应蛋白(CRP)等炎症因子水平,并使用急性生理学、慢性健康状况Ⅱ(APACHEⅡ)评分和序贯性器官功能衰竭(SOFA)评分对各组肺部感染并发脓毒症患者进行评分;肺部感染并发脓毒症患者的PD-L1、LAG-3和炎症因子与APACHEⅡ、SOFA评分的相关性采用Spearman法进行分析;影响肺部感染并发脓毒症患者预后的因素使用logistic回归曲线进行分析;血清PD-L1、LAG-3与炎症因子对肺部感染并发脓毒症患者预后预测价值采用受试者工作特征(ROC)曲线进行分析。结果 观察组血清PD-L1、LAG-3与IL-6、IL-8、PCT、CRP等炎症因子水平和APACHEⅡ、SOFA评分均显著高于健康对照组,差异有统计学意义(t=18.878、31.675、47.256、17.007、36.931、46.249、25.472、35.589,P<0.05);肺部感染并发脓毒症患者血清PD-L1、IL-6、IL-8、CRP水平和APACHEⅡ、SOFA评分在入院第3天开始上升,第5天降低,在入院第7天时与第1天差异有显著性统计学意义(F=45.102、291.957、38.741、51.782、23.215、100.872,P<0.05)。观察组患者血清PD-L1、LAG-3、IL-6、IL-8、IL-10、PCT、CRP水平与APACHEⅡ、SOFA评分均呈正相关(r=0.557、0.316、0.428、0.501、0.168、0.382、0.517,0.383、0.531、0.405、0.392、0.344、0.582、0.446,P<0.05)。生存组患者血清PD-L1、IL-6、IL-8、PCT、CRP水平和APACHEⅡ、SOFA评均显著低于死亡组(t=5.234、7.944、9.405、34.105、4.625、5.806、3.745,P<0.05)。PD-L1、IL-8Objective To investigate the expression levels and clinical significance of programmed death-ligand 1(PD-L1),lymphocyte activating gene 3(LAG-3),and inflammatory factors in the serum of patients with pulmonary infection complicated by sepsis.Methods 96 patients with pulmonary infection complicated by sepsis admitted to Honghu Traditional Chinese Medicine Hospital from June 2021 to July 2023 were retrospectively selected as the observation group,according to their prognosis of survival status,they were divided into 68 cases in the survival group and 28 cases in the death group,and 110 healthy people who had medical checkups in the same period of time in our hospital were used as the control group.Serum PD-L1,LAG-3,interleukin(IL)-6,IL-8,IL-10,procalcitonin(PCT),C-reactive protein(CRP),and other inflammatory factors levels were examined on days 1,3,5,and 7 of admission in the observation group,and Acute Physiology And Chronic Health EvaluationⅡ(APACHEⅡ)score and Sequential Organ Failure Assessment(SOFA)score were used to score the patients with pulmonary infections complicated by sepsis in each group;the correlation between PD-L1,LAG-3,inflammatory factors and APACHEⅡ,SOFA scores in patients with pulmonary infection complicated by sepsis was analyzed using Spearman method;the factors affecting the prognosis of patients with pulmonary infection complicated by sepsis were analyzed using Logistic regression curves;the prognostic value of serum PD-L1,LAG-3,and inflammatory factor levels in patients with pulmonary infection complicating sepsis was analyzed using the receiver operating characteristic(ROC)curve.Results Serum levels of PD-L1,LAG-3 with IL-6,IL-8,PCT,CRP,APACHEⅡand SOFA scores were significantly higher in the observation group compared to the control group(t=18.878,31.675,47.256,17.007,36.931,46.249,25.472,35.589,P<0.05).The serum levels of PD-L1,IL-6,IL-8,CRP,scores of APACHEⅡ,and SOFA in patients with pulmonary infection complicated by sepsis began to increased on the 3rd day of admission,decrea

关 键 词：肺部感染并发脓毒症 程序性死亡受体配体1 淋巴细胞激活基因3 炎症因子 预后 

分 类 号：R631[医药卫生—外科学]