中性粒细胞活化与急性肾综合征出血热疾病严重程度的相关性  

Correlation between neutrophil activation and severity of hemorrhagic fever with renal syndrome

作　　者：黄艳霞 万青[1] 张伟[2] 陈宏义[1] 罗芳[3] 窦龙姣 修松昌 饶建锋[1] 王莉 王淑梅[1] HUANG Yan-xia;WAN Qing;ZHANG Wei;CHEN Hong-yi;LUO Fang;DOU Long-jiao;XIU Song-chang;RAO Jian-feng;WANG Li;WANG Shu-mei(Department of Infectious Diseases,Hospital of infectious Diseases Affiliated to Nanchang University&Nanchang Ninth Hospital,Nanchang 330002,Jiangxi,China;不详)

机构地区：[1]南昌大学附属感染病医院,南昌市第九医院感染科,江西南昌330002 [2]南昌大学附属感染病医院,南昌市第九医院重症医学科,江西南昌330002 [3]南昌大学附属感染病医院,南昌市第九医院检验科,江西南昌330002

出　　处：《广东医学》2024年第5期610-614,共5页Guangdong Medical Journal

基　　金：江西省卫健委科技计划项目(202120070)。

摘　　要：目的探讨中性粒细胞活化在肾综合征出血热(hemorrhagic fever with renal syndrome,HFRS)发病机制中的作用。方法纳入21例HFRS患者(观察组)和18例健康者(对照组),按病情将观察组分为轻/中型组和重/危重型组,进行组间比较。检测各组血清中性粒细胞活化后产物包括髓过氧化物酶(myeloperoxidase,MPO)、人中性粒细胞弹性蛋白酶(human neutrophil elastase,HNE)、中性粒细胞细胞外陷阱(neutrophil extracellular traps,NETs)表达水平。比较观察组和对照组,轻/中型组和重/危重型组间表达差异。结果重/危重型组血中性粒细胞计数、尿素氮、血肌酐(Scr)水平显著高于轻/中型组(均P<0.05),血小板计数(PLT)明显低于轻/中型组(P<0.05)。观察组血清MPO、HNE、NETs表达水平显著高于对照组(均P<0.05);与轻/中型组相比,重/危重型组患者血清NETs表达水平显著升高,差异有统计学意义(P<0.05)。HFRS血清HNE水平与Scr正相关(r=0.472,P<0.05)。结论中性粒细胞活化可能与HFRS疾病严重程度有关,抑制NETs形成可能是未来HFRS的潜在治疗靶点。Objective To investigate the role of neutrophil activation in the pathogenesis of hemorrhagic fever with renal syndrome(HFRS).Methods Serum levels of neutrophil activation products,including myeloperoxidase(MPO),human neutrophil elastase(HNE),and neutrophil extracellular traps(NETs),were measured in 21 patients with HFRS and 18 healthy controls.Differences in expression levels were compared between the observed group and control group,as well as between the mild/medium and severe/critical subgroups.Results In the severe/critical subgroup,neutrophil count,blood urea nitrogen,and serum creatinine(Scr)levels were significantly higher,while platelet count(PLT)was significantly lower compared to the mild/medium subgroup(all P<0.05).Serum levels of MPO,HNE,and NETs in the observed group were significantly higher than those in the control group(all P<0.05).Compared to the mild/medium subgroup,patients in the severe/critical subgroup had significantly higher serum levels of NETs,with statistical significance(P<0.05).Serum HNE levels in HFRS were positively correlated with Scr(r=0.472,P<0.05).Conclusion Neutrophil activation may be associated with the severity of HFRS,and inhibition of NETs formation may be a potential therapeutic target for future HFRS treatment.

关 键 词：肾综合征出血热 中性粒细胞 髓过氧化物酶 中性粒细胞弹性蛋白酶 中性粒细胞胞外陷阱网 

分 类 号：R512.8[医药卫生—内科学] R392.7[医药卫生—临床医学]