脓毒症休克患儿血清炎性因子表达水平及与免疫功能和转归的相关性

Expression of serum inflammatory factor in children with septic shock and its correlations with immune function and outcome

目的探究脓毒症休克患儿白介素(IL)-2、IL-4以及IL-10表达水平与免疫功能以及转归之间的关系。方法收集南阳市中心医院2017年3月-2020年3月期间收治的104例脓毒血症患儿,依据患儿是否存在脓毒症休克,分为脓毒血症组(n=54)与脓毒症休克组(n=50),同时选择同期体检57名健康儿童作为对照组,三组均测定血清IL-2、IL-4、IL-10以及免疫功能,评估脓毒症休克组患儿转归情况。比较三组血清炎症以及免疫功能指标水平,分析血清炎症与免疫功能之间相关性,不同转归脓毒症休克患儿血清指标水平,分析血清指标水平对脓毒症休克患儿转归评估价值。结果对照组、脓毒血症组以及脓毒症休克组血清IL-2、IL-4以及IL-10水平依次增多,而CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平依次减少,差异有统计学意义(P<0.05);Pearson相关性分析显示,脓毒症休克患儿IL-2、IL-4、IL-10水平与CD4^(+)、CD8^(+)之间关系为负相关(P<0.05);转归良好组患儿IL-2、IL-4、IL-10水平显著低于转归不佳组患儿,差异有统计学意义(P<0.05);ROC曲线显示IL-2、IL-4、IL-10用于评估患者转归不良AUC值分别为0.806、0.754、0.859。结论脓毒症休克患儿血清IL-2、IL-4、IL-10高表达,且其异常表达状态与患者免疫功能异常有关,其血清这些细胞因子表达水平变化有助于评估患儿转归,为后期治疗提供参考依据。

Objective To explore the expression of interleukin(IL)-2,IL-4 and IL-10 in children with septic shock and its relationship with immune function and outcome.Methods 104 children with sepsis who had been treated in the hospital between March 2017 and March 2020 were divided into sepsis group(n=54)and septic shock group(n=50)according to the existence of septic shock.Meanwhile,57 healthy children were selected as the control group.Serum IL-2,IL-4 and IL-10 levels and immune function in all groups were measured,and the outcome of septic shock group was assessed.Levels of serum inflammatory factors and immune function indexes in the three groups were compared,and the correlation between serum inflammatory factors and immune function was analyzed.Serum indexes in septic shock children with different outcomes were analyzed,and value of serum indexes in outcome evaluation of children with septic shock was analyzed.Results Serum IL-2,IL-4 and IL-10 levels in the control group,sepsis group and septic shock group increased in sequence,while CD4+,CD8+and CD4+/CD8+levels decreased in sequence(P<0.05).Pearson correlation analysis showed that IL-2,IL-4 and IL-10 levels were negatively correlated with CD4+and CD8+in children with septic shock children(P<0.05).IL-2,IL-4 and IL-10 levels were significantly lower in children with good outcome than those with poor outcome(P<0.05).ROC curve showed that AUC values of IL-2,IL-4 and IL-10 in evaluating poor outcome were 0.806,0.754 and0.859,respectively.Conclusions Serum IL-2,IL-4 and IL-10 were elevated in children with septic shock,and their abnormal expression was related to abnormal immune function.Serum levels of the above factors were helpful to assess the outcome of children,thereby providing reference for subsequent treatment.