急性骨髓炎患者血清IFN-γ、IL-6及TNF-α动态变化及其临床意义

Dynamic Changes of Serum IFN-γ,IL-6 and TNF-αin Patients with Acute Osteomyelitis and Their Clinical Significances

目的探讨急性骨髓炎(AOL)患者血清干扰素-γ(IFN-γ)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)动态变化及其临床意义。方法病例源于2018年1月至2018年6月本院骨科收治的48例AOL患者和同期健康的42例骨折患者,分别记为疾病组、对照组,对比两组血清IFN-γ、IL-6及TNF-α水平,观察不同临床特征AOL患者血清IFN-γ、IL-6及TNF-α水平变化,并分析不同预后患者血清IFN-γ、IL-6及TNF-α动态变化及其临床意义。结果与对照组比较,疾病组血清IFN-γ明显降低、IL-6及TNF-α水平明显升高,差异有统计学意义(P<0.05),AOL患者血清IFN-γ、IL-6及TNF-α水平在性别、年龄、BMI分布上差异无统计学意义(P>0.05);但在感染部位分布上差异有统计学意义(P<0.05);AOL患者第1、3、5d IFN-γ水平依次明显升高、IL-6及TNF-α水平则依次明显降低(P<0.05),且入院后第1、3、5d与预后不良组比较,预后良好组血清IFN-γ水平明显升高、IL-6、TNF-α水平明显降低(P<0.05);AOL患者血清IFN-γ水平与预后呈明显正相关(r=0.421,P<0.01),而IL-6及TNF-α水平与预后呈明显的负相关(r=-0.368、-0.407,P<0.01)。结论AOL患者血清IFN-γ水平呈下降趋势、IL-6、TNF-α水平呈上调趋势,三者动态监测利于AOL患者预后评估及早期治疗方案的制定。

Objective To explore dynamic changes of serum interferon-γ(IFN-γ),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in patients with acute osteomyelitis(AOL)and their clinical significances.Methods 48 AOL patients who were admitted to orthopedics department of the hospital from January,2018 to June,2018 were selected as the case group,while 42 fractures patients who underwent physical examination in the same period were selected as controls.The levels of serum IFN-γ,IL-6 and TNF-αwere compared between the two groups.The changes in levels of serum IFN-γ,IL-6 and TNF-αin AOL patients with different clinical features were observed.The dynamic changes of serum IFN-γ,IL-6 and TNF-αin patients with different prognosis and their clinical significances were analyzed.Results Compared with the control group,serum IFN-γwas significantly lower,while IL-6 and TNF-αlevels were significantly higher in the disease group(P<0.05).There was no significant difference in serum IFN-γ,IL-6 and TNF-αamong AOL patients with different gender,age and BMI(P>0.05).However,there were significant differences in the distribution of infection sites(P<0.05).On the first,third and 5th day,level of IFN-γof AOL patients was significantly increased gradually,while levels of IL-6 and TNF-αwere significantly decreased gradually.On the first,third and 5th day after admission,compared with the poor prognosis group,level of serum IFN-γwas significantly higher,while levels of IL-6 and TNF-αwere significantly lower in the good prognosis group(P<0.05).Serum IFN-γlevel was significantly positively correlated with prognosis in AOL patients(r=0.421,P<0.01),while IL-6 and TNF-αlevels were significantly negatively correlated with prognosis(r=-0.368,-0.407,P<0.01).Conclusion The serum IFN-γlevel of AOL patients is decreased,while levels of IL-6 and TNF-αare increased.The dynamic monitoring of the three markers is beneficial to the prognosis evaluation and development of early treatment plan for AOL patients.