细胞因子谱联合NLR、PLR在布鲁氏菌病患者病程评估中的应用  

Application of cytokine profile combined with NLR and PLR in evaluating the course of brucellosis patients

作　　者：李艳丽 周坤 高庆峰 毕惠梅 Li Yanli;Zhou Kun;Gao Qingfeng;Bi Huimei(Clinical Laboratory of Beidahuang Group General Hospital,Harbin 150088,China)

机构地区：[1]北大荒集团总医院检验科,哈尔滨150088

出　　处：《中华地方病学杂志》2025年第4期292-297,共6页Chinese Journal of Endemiology

摘　　要：目的探讨布鲁氏菌病(简称布病)患者血清细胞因子白细胞介素(interleukin,IL)-2、IL-4、IL-6、IL-10、IL-17、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和干扰素-γ(interferon-γ,IFN-γ)水平及中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)在布病病程评估中的应用及其临床意义。方法采用病例-对照研究方法,2023年2月至2024年3月,选择在北大荒集团总医院收治确诊的274例布病患者[根据病程分为急性组(165例)、慢性组(109例)]和70例健康体检者(对照组)作为研究对象,采用流式微球阵列(cytometric bead array,CBA)法进行血清多细胞因子检测;同时进行血常规、试管凝集试验(serum agglutination test,SAT)和血培养等检测,并计算NLR和PLR。对不同病程、有无并发症、不同SAT抗体滴度水平[高滴度组(>1∶100)和低滴度组(≤1∶100)]、不同血培养结果患者进行细胞因子水平及NLR、PLR比较,并采用logistic回归分析各指标对布病病程的影响。结果急性组IL-2、IL-6、IL-10、IL-17、TNF-α和IFN-γ水平[M(Q 1,Q 3):0.32(0.15,0.70)、18.97(10.70,36.86)、2.54(1.49,4.36)、1.41(0.38,3.05)、1.31(0.77,2.33)、11.60(2.30,36.75)ng/L]均高于慢性组[0.18(0.06,0.43)、1.68(0.75,5.74)、0.88(0.40,1.93)、0.29(0.09,0.87)、0.59(0.31,1.07)、0.72(0.33,1.42)ng/L]和对照组[0.10(0.05,0.30)、1.52(0.09,2.80)、0.72(0.35,1.16)、0.08(0.03,0.20)、0.55(0.20,0.96)、0.68(0.41,1.25)ng/L,均P<0.05];有并发症组IFN-γ水平低于无并发症组,NLR和PLR均高于无并发症组(均P<0.05);高滴度组IL-6、IL-17、TNF-α和IFN-γ水平均高于低滴度组,NLR低于低滴度组(均P<0.05);急性组血培养阳性患者IFN-γ和TNF-α水平均高于血培养阴性患者(均P<0.05)。单因素分析显示,7种细胞因子均可影响布病病程(均P<0.05);多因素分析显示,IL-6、TNF-α和IFN-γ是布病病程的独立影响因素[OR(95%CI)=0.87(0.83,0.91)�ObjectiveTo investigate the application in evaluating the course and the clinical effects of serum cytokines interleukin(IL)-2,IL-4,IL-6,IL-10,IL-17,tumor necrosis factor-α(TNF-α),and interferon-γ(IFN-γ)levels,as well as neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in patients with brucellosis.MethodsUsing case-control method,from February 2023 to March 2024,274 confirmed brucellosis patients[divided into acute and chronic groups(n=165,109)according to the course of the disease]and 70 healthy individuals(control group)were selected at Beidahuang Group General Hospital for serum cytokines detection using cytometric bead array(CBA)method.Blood routine test,serum agglutination test(SAT)and blood culture were performed at the same time,and NLR and PLR were calculated.Cytokine levels,NLR,and PLR were compared in patients with different disease duration,with or without complications,with different SAT titers[high(>1∶100)and low(≤1∶100)],and with different blood culture results,and the effects of each indicator on the course of brucellosis were analyzed by logistic regression.ResultsThe levels of IL-2,IL-6,IL-10,IL-17,TNF-αand IFN-γin the acute group[M(Q 1,Q 3):0.32(0.15,0.70),18.97(10.70,36.86),2.54(1.49,4.36),1.41(0.38,3.05),1.31(0.77,2.33),11.60(2.30,36.75)ng/L]were higher than those in the chronic group[0.18(0.06,0.43),1.68(0.75,5.74),0.88(0.40,1.93),0.29(0.09,0.87),0.59(0.31,1.07),0.72(0.33,1.42)ng/L]and control group[0.10(0.05,0.30),1.52(0.09,2.80),0.72(0.35,1.16),0.08(0.03,0.20),0.55(0.20,0.96),0.68(0.41,1.25)ng/L,P<0.05].The IFN-γlevel in the group with complications of brucellosis was lower than that in the group without complications,while the NLR and PLR were higher than those in the group without complications(P<0.05).The levels of IL-6,IL-17,TNF-α,and IFN-γin the high titer group were higher than those in the low titer group,and the NLR was lower than that in the low titer group(P<0.05).The levels of IFN-γand TNF-αof blood culture positive patients in the acute gr

关 键 词：布鲁氏菌病 细胞因子 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 

分 类 号：R516.7[医药卫生—内科学]