血清sPLA2-X水平与支气管扩张症伴感染患者致炎-抑炎因子谱的相关性  

Correlation between serum sPLA2-X level and spectrum of proinflammatory and anti-inflammatory factors in patients with bronchiectasis complicated with infection

作　　者：李永海 梁珍玲 李灿豪 周星求 LI Yonghai;LIANG Zhenling;LI Canhao;ZHOU Xingqiu(Department of Emergency,Xiaolan People's Hospital of Zhongshan,Zhongshan,Guangdong,528415,China)

机构地区：[1]中山市小榄人民医院急诊科,广东中山528415

出　　处：《临床血液学杂志》2025年第2期142-147,共6页Journal of Clinical Hematology

摘　　要：目的:观察支气管扩张症(bronchiectasis, BCS)伴感染患者血清分泌型磷脂酶A2-X(secreted phospholipase A2-X,sPLA2-X)水平,并分析BCS伴感染患者sPLA2-X水平与致炎-抑炎因子谱的关系。方法:选择2019年1月—2021年12月收治的110例BCS患者作为研究对象。患者入院时均接受血清sPLA2-X检测,根据患者感染发生情况分组,将伴感染患者纳入感染组,将未伴感染患者纳入非感染组。统计两组基线资料,分析血清sPLA2-X水平与BCS患者伴感染的关系。感染组患者均接受抗感染治疗,分析患者治疗前、治疗后血清sPLA2-X水平与致炎-抑炎因子[肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)、C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-4(IL-4)、白细胞介素-17(IL-17)、白细胞介素-33(IL-33)]的关系。结果:110例BCS患者经痰培养确诊感染46例,发生率为41.82%;感染组第1秒用力呼气容积(forced expiratory volume in one second, FEV1)/用力肺活量(forced vital capacity, FVC)、sPLA2-X水平高于非感染组(P<0.05),病情严重程度为重度、合并COPD患者占比高于非感染组(P<0.05);感染组TNF-α、IFN-γ、CRP、IL-1β、IL-6、IL-4、IL-17、IL-33水平高于非感染组(P<0.001);行二元logistic回归分析结果显示,血清sPLA2-X高表达是BCS发生感染的危险因素(OR=1.066,P<0.001);感染组治疗后sPLA2-X水平为(209.35±16.67) ng/L低于治疗前(330.08±25.67) ng/L(P<0.001);感染组治疗后TNF-α、IFN-γ、CRP、IL-1β、IL-6、IL-4、IL-17、IL-33水平均低于治疗前(P<0.001);采取双相关变量Pearson分析sPLA2-X与致炎-抑炎因子水平的关系,sPLA2-X水平与TNF-α、IFN-γ、CRP、IL-1β、IL-6、IL-4、IL-17、IL-33水平呈正相关(P<0.001)。结论:sPLA2-X与BCS患者感染发生密切相关,同时与致炎-抑炎因子水平呈正相关。Objective:To observe the level of serum secretory phospholipase A2-X(sPLA2-X)in bronchiectasis(BCS)patients with infection,and analyze the relationship between sPLA2-X level and proinflammatory-antiinflammatory factor spectrum in BCS patients with infection.Methods:A total of 1l0 patients with BCS who were admitted to our hospital from January 2019 to December 2021 were included in the study.All patients were tested for serum sPLA2-X at the time of admission.They were grouped according to the incidence of infection in patients,and patients with infection were included in the infection group,while patients without infection were included in the non-infection group.The baseline data of the two groups were counted and the relationship between serum sPLA2-X levels and BCS patients with infection was analyzed.All patients in the infected group received anti-infection treatment,the relationship between the levels of serum sPLA2-X and proinflammatory-anti-inflammatory factor spectrum(tumor necrosis factor-α[TNF-α],interferon gamma[IFN-r],C-reactive protein[CRP],interleukin-1β[IL-1β].interleukin-6[IL-6],interleukin-4[IL-4],interleukin-17[IL-17]and interleukin-33[IL-33])was analyzed before and after the treatment.Results:Among 110 BCS patients,46 cases were diagnosed with infection by sputum culture,the incidence rate was 41.82%;The levels of FEV,/FVC and sPLA2-X in the infec-ted group were higher than those in the non-infection group(P<o.05),the severity of the disease was severe,and the proportion of patients with COPD was higher than that in the non-infection group(P<0.05).The levels of TNF-α,IFN-,CRP,IL-1β,IL-6,IL-4,IL-17 and IL-33 in infected group were higher than those in the non-infection group(P<0.001).Logistic regression analysis showed that the high expression of serum sPLA2-X was a risk factor for BCS infection(OR=1.066,P<0.001).The level of sPLA2-X in infected group was(209.35±16.67)ng/L after treatment,which was lower than that before treatment(330.08±25.67)ng/L(P<0.001).After treatment,the levels of

关 键 词：支气管扩张症 感染 分泌型磷脂酶A2-X 致炎-抑炎因子谱 

分 类 号：R446.11[医药卫生—诊断学]