肺部感染性脓毒症患者支气管肺泡灌洗液中PD-1、PD-L1与免疫抑制及预后的相关性研究  

Study on the Correlation Between PD-1,PD-L1 in Bronchoalveolar Lavage Fluid and Immune Suppression and Prognosis in Patients with Pulmonary Infectious Sepsis

作　　者：李莹 朱玮琪 陈虎[1] LI Ying;ZHU Weiqi;CHEN Hu(Internal Medicine,Kunshan Sixth People's Hospital,Kunshan,Jiangsu 215300,China)

机构地区：[1]江苏省昆山市第六人民医院重症医学科,江苏昆山215300

出　　处：《转化医学杂志》2024年第5期733-738,共6页Translational Medicine Journal

基　　金：昆山市科技专项(KS2245)。

摘　　要：目的探讨PD-1和PD-L1在支气管肺泡灌洗液(BALF)样本中作为检测标志物的可行性,为肺部感染性脓毒症患者的免疫抑制及预后评估提供有效指标。方法选取2022年7月至2023年12月江苏省昆山市第六人民医院及昆山市第一人民医院ICU病区的脓毒症患者为研究对象,采集患者静脉血和BALF,测定2种样本中程序性死亡蛋白-1(PD-1)、程序性死亡蛋白配体-1(PD-L1)的表达,以及静脉血中白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)的表达。结合SOFA、APACHEⅡ评分绘制受试者工作特征(ROC)曲线,分析PD-1、PD-L1与患者免疫抑制及预后的相关性。结果本研究共纳入60例符合标准的患者,根据28 d内的生存情况分为存活组(n=40)和死亡组(n=20)。存活组的IL-10表达高于死亡组(P<0.001),而PD-1、PD-L1及TNF-α表达低于死亡组(P<0.001);存活组的SOFA、APACHEⅡ评分较死亡组低(P<0.001);BALF中PD-1、PD-L1的检出率高于静脉血(P<0.001),(ROC)曲线优势明显。结论BALF中的PD-1和PD-L1可作为肺部感染性脓毒症患者用于评估预后的检测标志物。Objective To evaluate the potential of PD-1 and PD-L1 as biomarkers in BALF samples,providing effective indicators of immune suppression and prognosis evaluation in patients with pulmonary infectious sepsis.Methods Eligible patients were enrolled for research and their venous blood and BALF were collected.The expression of PD-1 and PD-L1 in both types of samples,as well as the expression of IL-10 and TNF-α in venous blood,was measured.ROC curves were plotted based on SOFA and APACHEII scores to analyze correlations.Results The expression level of IL-10(P<0.001)in the survival group was higher than that in the death group while the expression of PD-1,PD-L1,and TNF-α(P<0.001)were lower.The SOFA and APACHEII scores(P<0.001)of the survival patients were lower than those of the death patients.The detection rate of PD-1 and PD-L1 in BALF was higher than that in venous blood.ROC curves demonstrated obvious advantages.Conclusion PD-1 and PD-L1 in BALF samples are valuable as biomarkers for evaluating prognosis.

关 键 词：肺部感染性脓毒症 肺泡灌洗液 程序性死亡蛋白-1 程序性死亡蛋白配体-1 免疫抑制 

分 类 号：R714.253[医药卫生—妇产科学]