IL-6、CD14、CD64检测在感染所致肝衰竭患者中意义

Effect of detection of IL6,CD14 and CD64 in patients with infection-induced liver failure

目的:探究CD14、CD64、IL-6在感染所致肝衰竭中的变化和诊断价值。方法:选取2016年7月～2017年7月在我院住院治疗的30例感染所致肝衰竭患者作为感染组,选取同时期在我院接受治疗的30例肝衰竭患者作为未感染组,选取同时期在我院接受健康监测的体检者10例作为对照组。对于确诊的腹水感染肝衰竭患者进行药物治疗;采集患者腹水和空腹外周静脉血,利用美国BD公司生产的FACSCalibur流式细胞仪测定患者的CD14、CD64水平;采用电化学发光免疫法(ELISA法)检测血清中IL-6。结果:感染组(治疗前)患者血液中CD14、CD64、IL-6含量明显高于未感染组和对照组,差异具有统计学意义(P <0. 05);感染组(治疗前)患者腹水中CD14、CD64、IL-6含量明显高于未感染组,差异具有统计学意义(P <0. 05)。治疗前感染组患者外周血中CD14、CD64、IL-6含量均低于腹水中CD14、CD64、IL-6含量,组间数据差异具有统计学意义(P <0. 05)。结论:CD14、CD64、IL-6在感染所致肝衰竭的诊断中具有一定的参考价值,同时腹水检查的敏感性优于血清检查。

Objective: To explore the changes and diagnostic value of CD14,CD64,and IL-6 in secondary liver failure. Method: 30 patients with secondary liver infection who were hospitalized in our hospital from July 2016 to July 2017 were selected as the infection group. 30 patients with hepatic failure treated in our hospital during the same period were selected as uninfected groups. 10 cases of physical examinations in our hospital during the same period for health monitoring were selected as the control group. Patients with confirmed liver failure secondary to ascites infection were treated with drugs;ascites and fasting peripheral venous blood were collected. The levels of CD14 and CD64 in patients were measured using a FACSCalibur flow cytometer produced by BD,USA;IL-6 in serum was measured by an electrochemiluminescence immunoassay( ELISA). Results: The levels of CD14,CD64,and IL-6 in the blood of infected patients( before treatment) were( 46. 32 ± 8. 41) mg · L-1,( 12 942. 21 ±328. 18) mol/cell,( 2 148. 13 ± 894. 35) pg·dl-1,significantly higher than those of the uninfected group( 0. 62 ±0. 20) mg·L-1,( 1 028. 45 ± 139. 41) mol/cell,( 84. 42 ± 56. 26) pg·dl-1,and the control group( 0. 52 ±0. 11) mg·L-1,( 983. 95 ± 126. 27) mol/cell,( 13. 52 ± 12. 71) pg·dl-1,The levels of CD14,CD64,and IL-6 in the ascitic fluid of the infected group( before treatment) were( 61. 24 ± 6. 41) mg·L-1,( 14 815. 06 ± 362. 21)mol/cell,and( 9 720. 82 ± 7 910. 25) pg·dl-1,respectively. In the uninfected group( 1. 92 ± 1. 20) mg·L-1,( 836. 13 ± 103. 22) mol/cell,( 1 648. 31 ± 1 321. 45) pg·dl-1,the difference was statistically significant( P <0. 05). The levels of CD14,CD64,and IL-6 in the peripheral blood of the infected patients were( 46. 32 ± 8. 41)mg·L-1,( 12 942. 21 ± 328. 18) mol/cell,and( 2 148. 13 ± 894. 35) pg·dl-1,respectively. Lowere than those in the ascites,CD14,CD64,IL-6 content( 61. 24 ± 6. 41) mg·L-1,( 14 815. 06 ±362. 21) mol/cell,( 9 720. 82 ±7 910. 25) pg/dl,the difference between the data was statistically significant( P < 0. 05). Conclusion: CD 14,CD64 and IL-6 have some reference value in the diagnosis of liver failure caused by infection,and the sensitivity of ascites examination is better than that of serum.