血清CXCL-10和IL-27水平与艰难梭菌感染腹泻患者病情程度的相关性分析

Correlation Between Serum CXCL-10 and IL-27 Levels and Severity of Diarrhea Patients with Clostridium Difficile Infection

目的:研究艰难梭菌感染(CDI)腹泻患者血清CXC趋化因子配体-10(CXCL-10)和白介素-27(IL-27)水平的变化及其与病情严重程度间的相关性。方法:将150例腹泻患者根据Cd培养结果是否阳性将其观察组(Cd培养阳性者,n=90)和对照组(Cd培养阴性者,n=60),观察组患者又根据CDI疾病严重程度(severity score index,SSI)评分将其分为轻度亚组(评分<4分,n=38)和中—重度亚组(评分≥4分,n=52)。所有人员进行血清CXCL-10和IL-27检测,比较三组人员血清CXCL-10和IL-27水平间的差异,并分析血清CXCL-10和IL-27与CDI腹泻严重程度间的相关性。结果:三组人员血清CXCL-10和IL-27水平高低为:观察组>对照组>健康组(P<0.05);观察组中—重度亚组患者血清CXCL-10和IL-27水平明显高于轻度亚组(P<0.05)。观察组SSI评分为(4.68±1.73)分,其中轻度亚组SSI评分为(3.02±0.89)分,中—重度亚组SSI评分为(5.13±1.09)分。Spearman直线相关性分析发现观察组患者血清CXCL-10和IL-27水平与SSI评分间呈正相关性(r=0.317和0.368,P=0.002和0.000)。ROC曲线分析发现:血清CXCL-10、IL-27及二者联合对CDI腹泻的诊断曲线下面积(area under curve,AUC)分别为:0.846、0.853和0.874,诊断敏感性分别为85.25%、80.30%和82.75%,诊断特异性分别78.50%、82.55%和85.85%。结论:血清CXCL-10和IL-27有助于艰难梭菌感染腹泻患者病情严重程度的判断,具临床应用价值。

Objective:To study the changes of serum CXCL chemokine ligand-10(CXCL-10)and interleukin-27(IL-27)levels in diarrhea patients with Clostridium difficile infection(CDI)and their correlation with the severity of the disease.Metods:A total of 150 patients with diarrhea were divided into observation group(positive Cd culture,n=90)and control group(negative Cd culture,n=60)according to the results of Cd culture.The patients in observation group were further divided into mild subgroup(score<4,n=38)and moderate-severe subgroup(score≥4,n=52)according to the severity score(SSI)of CDI.The serum levels of CXCL-10 and IL-27 were detected in all the three groups,and the correlation between the serum levels of CXCL-10 and IL-27 and the severity of CDI diarrhea was analyzed.Results:The serum levels of CXCL-10 and IL-27 in the three groups were as follows:observation group>control group>healthy group(P<0.05);the serum levels of CXCL-10 and IL-27 in the moderate-severe subgroup were significantly higher than those in the mild subgroup(P<0.05).The SSI score of the observation group was(4.68±1.73),the SSI score of the mild subgroup was(3.02±0.89),and the SSI score of the moderate-severe subgroup was(5.13±1.09).Spearman linear correlation analysis showed that there was a positive correlation between serum CXCL-10 and IL-27 levels and SSI score in the observation group(r=0.317 and 0.368,P=0.002 and 0.000).ROC curve analysis showed that the area under curve(AUC)of serum CXCL-10,IL-27 and their combination in the diagnosis of CDI diarrhea were 0.846,0.853 and 0.874 respectively,the diagnostic sensitivity was 85.25%,80.30%and 82.75%respectively,and the diagnostic specificity was 78.50%,82.55%and 85.85%respectively.Conclusion:Serum CXCL-10 and IL-27 can help judge the severity of diarrhea in patients with Clostridium difficile infection,which has clinical application value.