脓毒症患者细胞因子水平与免疫功能相关性临床研究

Correlation between cytokine levels and immune function in patients with sepsis

目的探讨脓毒症患者细胞因子与免疫功能的关系及其对预后的预测价值。方法选取郑州人民医院2020年1月至2021年12月间收治的57例脓毒症患者,其中男性29例,女性28例;年龄41~97岁,平均78岁。根据是否存在脓毒症休克,分为脓毒症组与脓毒症休克组,记录两组患者IL-2、IL-4、IL-10水平、急性生理与慢性健康评分(APACHEⅡ)、序贯器官衰竭评分(SOFA),分析各指标与免疫功能的关系,比较其与患者预后的关系,评估其预测价值。结果脓毒症休克组IL-2、IL-4、IL-10水平均高于脓毒症组,而CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平低于脓毒症组,差异有统计学意义(P<0.05),IL-2、IL-4、IL-10与CD4^(+)、CD8^(+)呈负相关性(P<0.05),与CD4^(+)/CD8^(+)无相关性(P>0.05),IL-2、IL-4、IL-10水平脓毒症患者28 d预后的受试者工作特征(ROC)曲线显示ROC曲线下面积(AUC)分别为0.744、0.698、0.871。结论脓毒症患者的高水平炎症因子与免疫功能低下相关,IL-2、IL-4、IL-10的升高对脓毒症患者不良预后均具有良好预测价值。

Objective To investigate the relationship between IL-2,IL-4,IL-10,immunefunction indexes and their predictive value for prognosis.Methods A total of 57 patients with sepsis admitted to Zhengzhou People’s Hospital from January 2020 to December 2021 were selected,including 29 males and 28 females,aged 41-97 years,with an average of 78 years.According to the presence or absence of septic shock,they were divided into a sepsis group and a septic shock group.The levels of IL-2,IL-4,IL-10,APACHEⅡ(acute physiology and chronic health score)and sequential organ failure score(SOFA)were recorded,the relationship between each index and immune function was analyzedwith comparison with patients’prognosisand evaluation of its predictive value.Results The levels of IL-2,IL-4 and IL-10 in the septic shock group were higher than those in the sepsis group,while the levels of CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)were lower than those in the sepsis group,and the differences were statistically significant(P<0.05);IL-2,IL-4 and IL-10 were negatively correlated with CD4^(+)and CD8^(+)(P<0.05),but had not correlated with CD4^(+)/CD8^(+)(P>0.05),Results The levels of IL-2,IL-4andIL-10 in the septic shock group were higher than those in the sepsis group,while the levels of CD4^(+),CD8^(+),CD4^(+)/CD8^(+)were lower than those in the sepsis group,and the differences were statistically significant(P<0.05);IL-2,IL-4,IL-10 were negatively correlated with CD4^(+)and CD8^(+)(P<0.0),but had no correlation with CD4^(+)/CD8^(+)(P>0.05).The receiver operating characteristic(ROC)curve display values of L-2,IL-4,IL-10 levels and 28-day prognosis of sepsis patients were 0.744,0.698and 0.871,respectively.Conclusion High levels of inflammatory factors in patients with sepsis are associated with low immune function.The elevations of IL-2,IL-4 and IL-10 have good predictive value for the poor prognosis of patients with sepsis.