布鲁杆菌病患者急性期和慢性期血清白细胞介素18和33的表达差异

Different expression of interleukin 18 and interleukin 33 in peripheral blood of patients with acute and chronic brucellosis

目的:探究急、慢性期以及治疗后的布鲁杆菌病(简称"布病")患者血清IL-18和IL-33的表达差异,探索其临床价值。方法:收集2019年5—7月新疆维吾尔自治区第六人民医院收治的52例布病患者(其中急性期患者27例、慢性期患者25例)作为病例组,并纳入26名健康体检者为对照组,采用流式液相多重蛋白定量技术(CBA)测定血液样本中IL-18、IL-33的表达。同时收集所有研究对象炎症指标血沉(ESR)以及C反应蛋白(CRP)的实验室检测结果。比较不同组间IL-18、IL-33、ESR、CRP的表达水平差异,采用Pearson法分析指标相关性,并绘制不同指标的ROC曲线。结果:布病急性期、慢性期与对照组血清IL-18和IL-33水平比较差异均有统计学意义(F=16.344和22.028,P均<0.01)。其中急性组IL-18、ESR和CRP表达分别为(272.07±170.18)ng/L、(39.56±24.52)mm/h和(22.82±29.00)mg/L,均高于慢性组(t=3.445、6.403和3.342,P均<0.05);慢性组IL-33表达为(436.22±56.10)ng/L,高于急性组(t=2.113,P<0.05)。急性期患者的IL-18和IL-33表达水平在药物治疗后均低于治疗前(t=4.213和6.096,P均<0.01)。相关性分析提示,IL-33水平与CRP水平呈正相关(r=0.460,P<0.05);进一步行ROC曲线分析显示,IL-18、IL-33、ESR、CRP联合检测曲线下面积为0.972。结论:IL-18和IL-33分别在布病急、慢性期中高表达,对于布病的联合诊断具有一定的临床价值。IL-18和IL-33的动态变化可能提示布病患者机体免疫由Th1向Th2转变。

Objective To investigate the differential expression levels of serum IL-18 and IL-33 in patients with acute and chronic brucellosis and to explore the clinical value.Methods A total of 52 patients with brucellosis(including 27 patients in the acute phase and 25 patients in the chronic phase)admitted to the Sixth Peopled Hospital of Xinjiang Uyghur Autonomous Region from May to July 2019 were enrolled as the case group and 26 healthy people were enrolled as the control group.The expression levels of serum IL-18 and IL-33 were determined by flow cytometry(CBA).Laboratory results of inflammatory markers of erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were also collected for all subjects.The levels of IL-18,IL-33,ESR and CRP were compared among different groups.The correlation of indicators was analyzed by Pearson method,and diagnostic values of different indicators were analyzed by ROC curves.Results The levels of serum IL-18 and IL-33 in the acute group,chronic group and control group of brucellosis were significantly different(F=16.344 and 22.028,Pboth<0.01).Compared with chronic group,the levels of IL-18,ESR and CRP in acute group[(272.07±170.18)ng/L,(39.56±24.52)mm/h and(22.82±29.00)mg/L]were significantly higher(t=3.445,6.403 and 3.342,P all<0.05).Compared with acute group,the level of IL-33 in chronic group[(436.22±56.10)ng/L]was significantly higher(t=2.113,P<0.05).After antimicrobial treatment,the expression levels of IL-18 and IL-33 in acute group decreased(t=4.213 and 6.096,P both<0.01).Correlation analysis showed a positive correlation between IL-33 and CRP(r=0.460,P<0.05).ROC curve analysis showed that the area under the curve of IL-18,IL-33,ESR and CRP-joint detection was 0.972.Conclusions IL-18 and IL-33 are highly expressed in the acute and chronic stages of brucellosis,respectively.It has certain clinical value for the joint diagnosis of brucellosis.The dynamic changes of IL-18 and IL-33 may indicate that the immunity of the body changes from Th 1 to Th2 in patients with brucellosis.