流行性感冒患者血清高尔基体蛋白73水平变化

Changes of serum Golgi protein 73 of patients with influenza

目的探讨血清高尔基体蛋白73(GP73)水平在流行性感冒(流感)患者中的变化以及对预后转归的影响。方法收集2017年7月至2018年10月于中国人民解放军联勤保障部队第九一O医院住院的流行性感冒患者83例(流感患者组),选择同期健康体检者50例为对照组。采用ELISA法检测血清GP73浓度,观察流感患者入院发热时、退热后及出院随访1个月时血清GP73水平、降钙素原(PCT)和白细胞介素-6(IL-6)的变化。血清GP73、PCT和IL-6水平采用中位数(四分位间距)表示。采用方差分析进行组间差异比较,治疗前后各指标变化采用Wilcoxon检验,变量间相关性分析采用线性回归和Spearman秩相关系数(r)进行评价。结果 83例流感患者检出A型流感病毒72例(86.75%),B型流感病毒11例(13.25%)。72例A型流感病毒中,检出H3亚型65例(90.28%),H1亚型7例(9.72%),未检出H5、H7、H9等其他亚型流感病毒。流感患者入院发热时血清GP73浓度为137.7(100.6,179.4)ng/ml,显著高于健康体检者[32.9(23.0,52.25)ng/ml],差异有统计学意义(F=12.30、P <0.001)。流感患者入院发热时IL-6浓度为[12.98(11.28,19.80)] ng/ml,显著高于健康体检者[1.52(1.31,1.72)ng/ml],差异有统计学意义(F=15.61、P <0.001);血清PCT含量为0.032(0.022,0.082)ng/ml略高于健康体检者[0.025 ng/ml(0.019,0.035)ng/ml],但差异无统计学意义(F=1.52、P=0.253)。流感患者退热后血清GP73含量快速下降,退热后及随访1个月血清GP73含量分别为80.13(60.20,96.54)ng/ml和46.65(40.47,55.59)ng/ml,与流感患者入院发热时血清GP73浓度[137.7(100.6,179.4)ng/ml]比较,差异均具有统计学意义(Z退热后vs.发热时=-9.46、P <0.001;Z随访1个月vs.发热时=-15.23、P <0.001)。结论流感患者发热时血清GP73浓度显著升高,退热后快速下降。血清GP73可能作为急性期炎症损伤或修复的快速反应蛋白,参与流感患者炎症损伤和修复过程。

Objective To investigate the changes of serum Golgi protein 73(G73)of patients with influenza and the effect on the outcome of prognosis.Methods From July 2017 to October 2018,a total of 83 patients with influenza(influenza group)who were hospitalized in the 910th Hospital of the People’s Liberation Army were collected,and 50 healthy cases for physical examination were selected as the control group.Serum GP73 concentration was detected by ELISA method.The changes of serum GP73,procalcitonin(PCT)and interleukin-6(IL6)levels were detected in patients with influenza at the timepoints of admission with fever,after fever and 1 month after discharge from hospital.The levels of serum GP73,PCT and IL-6 were expressed by median(quartile spacing).Variance analysis was applied to compare the differences of the above indexes between patients of the two groups.Wilcoxon test was applied to analyze the changes of each index before and after treatment,and linear regression and Spearman rank correlation coefficient(r)were used to evaluate the correlation between variables.Results Total of 72 patients(86.75%)with influenza A virus infection and 11 cases(13.25%)of influenza B virus infection were detected among 83 patients with influenza.Among the 72 cases with influenza A virus infection,65 cases(90.28%)were H3 subtype and 7 cases(9.72%)were H1 subtype.No other subtypes of influenza virus,such as H5,H7,H9 and so on were detected.The serum GP73 concentration of influenza patients with fever was 137.7(100.6,179.4)ng/ml,which was significantly higher than that of control group[32.9(23.0,52.25)ng/ml],with significant difference(F=12.30,P<0.001).The IL-6 concentration of patients with influenza when admitted to hospital with fever was[12.98(11.28,19.80)]ng/ml,significantly higher than that of control group[1.52(1.31,1.72)ng/ml],with significant difference(F=15.61,P<0.001),and the level of serum PCT was 0.032(0.022,0.082)ng/ml,slightly higher than that of control group[0.025 ng/ml(0.019,0.035)ng/ml],but with no significant difference(F=1.52,P=0.253).The serum G73 content of patients with influenza was significantly decreased,and the content of serum G73 was 80.13(60.20,96.54)ng/ml and 46.65(40.47,55.59)ng/ml after fever and follow-up for 1 month;and compared with the concentration of serum G73[137.7(100.6,179.4)ng/ml]of the patients with fever when admitted to hospital,both with significant differences(afer fever vs.at fever:Z=-9.46,P<0.001;follow-up for 1 month vs.at fever:Z=-15.23,P<0.001).Conclusions The concentration of serum GP73 of influenza patients with fever increased significantly and decreased rapidly after fever.Serum GP73 may be involved in the process of inflammatory injury and repairment of patients with influenza,which could be taken as a rapid reaction protein for injury or repairment of acute inflammation.