登革热血清趋化因子CCL17和CXCL5与CXCL9表达及临床意义

Expression of serum chemokines CCL17, CXCL5 and CXCL9 in dengue fever patients and their clinical significance

目的探讨登革热患者血清趋化因子(CCL)17、CXC基序趋化因子(CXCL)5、CXCL9表达改变及临床意义。方法选择杭州市第三人民医院2017年9月-2020年5月确诊的66例登革热患者为登革热组,同期进行体检的健康人群30名为对照组。登革热组患者根据病情严重程度分为轻症组与重症组,根据发病期分为感染早期组、感染期组与恢复期组,根据是否初次感染分为初次感染组与再次感染组。采用酶联免疫吸附法检测血清中CCL17、CXCL5、CXCL9水平,分析血清CCL17、CXCL5、CXCL9水平对于重症登革热患者的诊断价值。结果重症组血清CCL17、CXCL5、CXCL9水平高于轻症组及对照组,轻症组血清CCL17、CXCL5、CXCL9水平高于对照组,差异具有统计学意义(P<0.05);感染期组血清CCL17、CXCL5、CXCL9水平高于感染早期组及恢复期组,感染早期组血清CCL17、CXCL5、CXCL9水平高于恢复期组,差异具有统计学意义(P<0.05);初次、再次感染患者血清CCL17、CXCL5、CXCL9水平比较,无统计学差异;受试者工作特征曲线(ROC)分析结果显示,血清CCL17、CXCL5、CXCL9用于重症登革热患者的诊断,其曲线下面积分别为0.755、0.761、0.782,均具有统计学意义(P<0.05)。结论登革热患者血清趋化因子CCL17、CXCL5、CXCL9表达水平与病情严重程度、疾病发展有关,但与初、再次感染无关,可作为重症登革热的诊断生物标志物。

OBJECTIVE To explore the changes of expression of serum chemotactic factor(CCL) 17, CXC motif chemokine(CXCL) 5, CXCL9 in patients with dengue fever and analyze their clinical significance. METHODS Totally 66 patients who were diagnosed with dengue fever in Hangzhou Third People’s Hospital from Sep 2017 to May 2020 were assigned as the dengue fever group, meanwhile, 30 healthy people who received physical examination were set as the control group. The patients of the dengue fever group were divided into the mild group and the severe group according the severity of disease, the patients were divided into the early infection group, the infection period group and the recovery period group according to the onset period, and the patients were divided into the initial infection group and the re infection group according to the status of initial infection. The levels of serum CCL17, CXCL5 and CXCL9 were detected by using enzyme-linked immunosorbent assay, and the diagnostic values of the serum CCL17, CXCL5 and CXCL9 for the severe dengue fever patients were observed. RESULTS The levels of serum CCL17, CXCL5 and CXCL9 of the severe group were significantly higher than those of the mild group and the control group, the levels of serum CCL17, CXCL5 and CXCL9 of the mild group were significantly higher than those of the control group(P<0.05). The levels of serum CCL17, CXCL5 and CXCL9 of the infection period group were significantly higher than those of the early infection group and the recovery group, the levels of serum CCL17, CXCL5 and CXCL9 of the early infection group were significantly higher than those of the recovery group(P<0.05). There were no significant differences in the levels of serum CCL17, CXCL5 and CXCL9 between the initial infection group and the reinfection group. Receiver characteristic curve(ROC) analysis showed that the areas under curve of the serum CCL17, CXCL5 and CXCL9 were respectively 0.755, 0.761 and 0.782 in diagnosis of the patients with severe dengue fever, and there were significant differences(P<0.05). CONCLUSION The expression levels of serum chemokines CCL17, CXCL5 and CXCL9 in the dengue fever patients are associated with the severity of disease and progression of disease but are not associated with the initial infection or reinfection, and they can be used as biomarkers for diagnosis of severe dengue fever.