细胞因子 IL－15在急性呼吸窘迫综合征发病中的作用

Clinical research of IL-15 cytokines and acute respiratory distress syndrome

目的：探讨细胞因子IL －15在急性呼吸窘迫综合征（ acute respiratory distress syndrome， ARDS）发病中的作用。方法入选2013－06～2014－08新疆医科大学第一附属医院急诊科ARDS患者28例为研究对象（ ARDS组），选择同期健康体检者22例为对照组，收集确诊ARDS患者第1天的临床资料，根据柏林定义分中度组（18例）和重度组（10例），随访28 d根据预后分存活组（13例）和死亡组（15例）。在确诊ARDS第1天、第3天清晨空腹抽外周静脉血3 mL，对照组抽空腹外周静脉血3 mL，检测两组血清IL－15浓度，并进行数据统计分析。结果确诊ARDS第1天，死亡组pH明显低于存活组（ P＜0．05）；ARDS组患者外周静脉血清IL－15水平明显高于对照组（ P＜0．05）；中度组与重度组患者IL －15水平比较差异无统计学意义（ P＞0．05）；存活组与死亡组患者IL－15水平比较差异无统计学意义（P＞0．05）。 ARDS确诊第3天，中度组患者IL－15水平明显低于重度组患者（ P＜0．05）；死亡组患者IL－15水平明显高于存活组（P＜0．05）。 Logistic回归分析显示，病情严重程度（OR＝1．017，95％CI 0．12～8．643，P＝0．988）、pH（OR＝0，95％CI 0～20．14，P＝0．143）、确诊ARDS第3天IL－15（OR＝1．025，95％CI 0．12～8．643，P＝0．991～1．06）不构成ARDS预后的危险因素。结论 ARDS患者IL－15水平明显高，早期外周静脉血清IL－15水平可有助于评估ARDS严重程度和预测其预后。

Objective To investigate the function of IL-15 cytokines in the pathogenesis of acute respiratory distress syndrome （ ARDS） patients.Methods Twenty-eight cases of ARDS patients in the Department of Emergency of the First Affiliated Hospital of Xinjiang Medical University collected from June, 2013 to July, 2014 were enrolled in our study, as study group （ ARDS group） , at the same time 22 cases of healthy subjects were selected as control group.Clinical base data after diagnosis of ARDS on the first day were collected, the ARDS patients were divided into moderate group （ n=18） and Severe group （ n =10 ） according to Berlin definition of ARDS, and also divided into two groups according to the survival of patients followed up for 28 days：non-survival group （ n=15 ） and survival group （n=13）.3 mL fasting peripheral venous blood was collected in the early morning from ARDS patients on the first and third day after diagnosis of ARDS and healthy subjects were used to be monitored IL-15 cytokines level of peripheral venous blood, then the data were analyzed.Results On the first day after diagnosis of ARDS, PH in non -survival group was significantly lower than that in survival group （ P〈0.05）;peripheral IL-15 level in ARDS group was significantly higher than that in healthy control group （P〈0.05）;peripheral IL-15 level between moderate group and severe group showed no statistically significant differences （ P 〉0.05）; peripheral IL -15 level between survival group and non-survival group also showed no statistically significant differences （P〉0.05）.On the third day,IL-15 level in severe group was significantly higher than that in moderate group （P〈0.05）, and that in survival group was significantly lower than that in non -survival group （ P 〈0.05 ）.Logistic regression analysis showed that severity of ARDS （OR=1.017, 95% CI 0.12~8.643, P=0.988）, PH （OR=0, 95%CI 0~20.14, P=0.143）, IL-15 on the third day after diagnosis of ARDS （OR=1.025, 95%CI 0.12~8.643, P=0.991-1.06） were not related with the risk of prognosis of ARDS. Conclusion Peripheral IL-15 level in ARDS patients are significantly high, and it is helpful for the assess of ARDS patients severity in the early stage, and for prognosis judgement.