流式CBA检测TH1/TH2细胞因子谱在细菌感染中的应用

Analysis of TH1/TH2 Cytokine Profiles by Flow Cytometry CBA Technologyin Bacterial Infection Patients

目的探讨流式细胞术(FCM)微球芯片技术(CBA)分析TH1/TH2细胞因子谱在细菌感染中的应用价值。方法CBA方法检测67例健康对照,111例细菌感染患者,42例非细菌感染患者TH1/TH2细胞因子表达水平,同时对比各组C反应蛋白(CRP)水平,绘制各指标的受试者工作特征(ROC)曲线并评价TH1/TH2细胞因子谱用于诊断细菌感染的价值。结果TH1细胞因子在G+细菌感染组和G-细菌感染组表达水平略高于健康对照组。TH2部分细胞因子在G+细菌感染组和G-细菌感染组表达水平显著高于健康对照组。其中IL-6在G+细菌感染组和G-细菌感染组表达水平显著高于健康对照组(P均<0.01),达10倍以上,IL-10在G-细菌感染组表达水平显著高于健康对照组(P<0.01),达10倍以上。ROC曲线下面积比较,IL-6/G+细菌感染组与CRP G+细菌感染组比较差异有统计学意义(z=4.49,P<0.01)。IL-6/G-细菌感染组与CRP/G-细菌感染组比较差异有统计学意义(z=4.64,P<0.01)。IL-10/G-细菌感染组与CRP/G-细菌感染组比较,差异有统计学意义(z=4.38,P<0.01)。抗菌治疗后7天,IL-6、IL-10在细菌感染患者中的表达水平基本恢复正常,而CRP表达水平仍高于正常(P均<0.01)。结论CBA技术分析的TH1/TH2细胞因子谱早期诊断细菌感染性能优于CRP,并能进一步辅助鉴别G+细菌和G-细菌感染及临床疗效判断。

Objective To investigate the application value of flow cytometry(FCM)microsphere microarray(CBA)technology in analysis of TH1/TH2 cytokine profiles in patients with bacterial infection.Methods CBA method was used to detect the expression of TH1/TH2 cytokines and C-reactive protein(CRP)levels in 42 patients with non-bacterial infection,111 patients withbacterial infection,and 67 healthy controls.The value of TH1/TH2 cytokine profiles in the diagnosis of bacterial infection was evaluated by drawing the Receiver Operating Characteristic(ROC)curve of each index.Results The expression level of TH1 cytokines in G bacterial infection group and G-bacterial infection group was slightly higher than that in healthy control group.Partial TH2 cytokines expression level in G+bacterial infection group and G-bacterial infection group were significantly higher than that in healthy control group.The expression level of IL-6 in G+bacterial infection group and G-bacterial infection group was significantly higher than that in healthy control group(P<0.01),more than 10 times,and the level of IL-10 in G-bacterial infection group was also more than 10 times higher than that in healthy control group(P<0.01).According to the area under the ROC curve,there was a significantly difference between the CRP/G+group and the IL-6/G+group(z=4.49 P<0.01),a significant difference between the IL 6/G+group and the CRP/G-bacterial infection group(z=4.64,P<0.01),and a significant difference between CRP/G-bacterial infection group and IL-10/G-bacterial infection group(z=4.38,P<0.01).The level of IL-6 and IL-10 in bacterial infection patients returned to normal after 7 days treatment,but the expression of CRP was still higher than that of normal(P<0.01).Conclusion The TH1/TH2 cytokine profileswas superior to that of CRPin the early diagnosis of bacterial infection,and it could further assist in the identification of G+and G-bacterial infections and the clinical efficacy.