细菌性肺炎儿童外周血中性粒细胞中Wip1的表达和临床意义

Expression and clinical significance of Wip1 in peripheral blood neutrophils in children with bacterial pneumonia

目的探讨细菌性肺炎儿童外周血中性粒细胞中Wip1的表达及临床意义。方法选取2016年1月~2017年1月间于我院确诊的细菌性肺炎患儿60例作为病例组,选取同时期健康儿童60例设为对照组,检测两组儿童红细胞沉降率(ESR)、白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)、全血超敏C-反应蛋白(CRP)、血清降钙素原(PCT)水平,应用流式细胞仪检测各组外周血中性粒细胞中Wip1和ROS表达水平,比较组间各指标差异,分析Wip1与其它各指标的相关性,ROC曲线分析外周血中性粒细胞中Wip1表达水平诊断价值。结果与对照组相比,病例组ESR、IL-6、IL-8、TNF-α、CRP及PCT均明显升高(P<0.01)。与对照组相比,病例组中性粒细胞Wip1+百分率明显降低(P=0.0001),病例组患儿中性粒细胞ROS平均荧光强度(MFI)较对照组明显升高(P<0.0001)。Wip1与IL-6、CRP、PCT、ROS呈负相关(P<0.05),与ESR、IL-8、TNF-α无相关性(P>0.05)。ROC曲线分析中性粒细胞中Wip1曲线下面积为0.9536(P<0.0001);中性粒细胞Wip1+百分率的诊断阈值为7.21%,灵敏度和特异性分别为88.33%和90.00%。结论细菌性肺炎儿童外周血中性粒细胞Wip1表达降低,可能与自身ROS及循环中IL-6、CRP及PCT增加有关,并可能是潜在的诊断标志物。

Objective To explored the expression and clinical significance of Wip1 in peripheral blood neutrophils in children with bacterial pneumonia.Methods 60 children with bacterial pneumonia and healthy children diagnosed in our hospital from January 2016 to January 2017 were selected as case group and control group.Erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),total Blood high-sensitivity C-reactive protein(CRP)and serum procalcitonin(PCT)levels were detected.Flow cytometry was used to detect the expression levels of Wip1 and ROS in peripheral blood neutrophils of each group.The differences between the indicators were compared and the correlation between Wip1 and other indicators was analyzed.Results Compared with the control group,ESR,IL-6,IL-8,TNF-α,CRP and PCT in the case group were significantly increased(P<0.01).The percentage of neutrophil Wip1+in the control group and the case group was(13.88±0.79)%and(4.32±0.33)%.Compared with the control group,the percentage of Wip1+in the case group was significantly lower(P=0.0001).The mean fluorescence intensity(MFI)of neutrophil ROS in the control group and the case group was(4.16±0.44)%and(18.04±0.98)%.Compared with the control group,the ROS MFI in the case group was significantly increased(P<0.0001).Wip1 was negatively correlated with IL-6(r=0.3205,P=0.0188),CRP(r=0.3842,P=0.00244),PCT(r=0.3009,P=0.0195),ROS(r=0.4039,P=0.0014).ROC curve analysis showed that the area under Wip1 curve in neutrophils was 0.9536(P<0.0001).The diagnostic threshold of neutrophil Wip1 positive rate was 7.21%,sensitivity and specificity were 88.33%and 90.00%,respectively.Conclusion The decrease of Wip1 expression in peripheral blood neutrophils in children with bacterial pneumonia may be a potential diagnostic marker.The decrease of Wip1 expression may be related to the increase of autologous ROS and circulating IL-6,CRP and PCT.