发热伴血小板减少综合征患者血清细胞因子与趋化因子特点分析

Serum cytokines and chemokines in patients with severe fever with thrombocytopenia syndrome

目的探讨发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)患者血清细胞因子与趋化因子水平与病情严重程度的关联。方法收集济南市2014—2017年47例SFTS患者血清,其中11例死亡患者血清为死亡组,36例幸存患者血清为幸存组,同时选取10例健康组血清作为对照组。利用Luminex液相芯片检测分析外周血清40种细胞因子与趋化因子表达水平。结果SFTS死亡组患者血清中27种细胞因子与趋化因子表达水平较对照组显著升高(P<0.05);死亡组患者33种细胞因子与趋化因子表达水平较幸存组明显升高(P<0.05);幸存组患者血清中12种细胞因子与趋化因子表达水平较对照组显著升高(P<0.05)。与急性期相比,恢复期患者10种细胞因子与趋化因子的表达水平有不同程度的升高(P<0.05);5种细胞因子与趋化因子在恢复期的表达水平低于急性期(P<0.05)。受试者工作特征曲线(receiver operating characteristic curve,ROC curve)分析发现,22种细胞因子与趋化因子有统计学意义,可做为预测患者疾病严重程度的生物标志物。结论SFTS患者血清中多种细胞因子与趋化因子表达水平在病情发展过程中发生显著变化。

Objective Serum cytokines and chemokines in patients with fever with thrombocytopenia syndrome(SFTS)and the severity of the disease was studied.Methods Serum of 47 SFTS patients from 2014 to 2017 in Jinan city was collected.Serum of 11 dead patients and 36 survivors were selected as the survival group and serum of 10 healthy people was selected as the control group.Luminex liquid phase chip was used to detect and analyze the expression levels of 40 cytokines and chemokines in peripheral blood.Results The expression levels of 27 cytokines and chemokines in the death group were significantly higher than those in the control group(P<0.05).The expression level of 33 cytokines and chemokines in the death group was significantly higher than that in the survival group(P<0.05).The expression level of 12 cytokines and chemokines in the survival group was significantly higher than that in the control group(P<0.05).The expression levels of 10 cytokines and chemokines in the patients were increased in different degrees during the recovery period compared with the acute period(P<0.05).The expression levels of 5 cytokines and chemokines were lower in the recovery period than in the acute period(P<0.05).Receiver operating characteristic curve(ROC curve)analysis showed that 22 factors were statistically significant and could be used as biomarkers to predict the severity of the disease.Conclusions The expression levels of various cytokines and chemokines in serum of SFTS patients changed significantly during the development of the disease and the cytokine storm caused by SFTS may be the cause of death.