外周血单核细胞IL-12、IL-15、ISG15表达与老年冠心病并发肺部感染预后的关系

Relationship between expression of IL-12,IL-15 and ISG15 in peripheral blood mononuclear cells and prognosis of elderly coronary heart disease patients complicated with pulmonary infection

目的 检测白细胞介素-12(IL-12)、IL-15及干扰素刺激基因15(ISG15)在老年冠心病并发肺部感染患者外周血单核细胞(PBMCs)的表达及其与预后的关系。方法 收集2018年11月-2020年10月诸暨市中医医院收治的老年冠心病患者213例,根据患者是否并发肺部感染分为感染组115例和非感染组98例。记录两组入院后第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰流速(PEF);采用受试者工作特征(ROC)曲线评价外周血单核细胞IL-12、IL-15及ISG15对老年冠心病并发肺部感染预后的临床价值。结果 115例老年冠心病并发肺部感染患者共培养分离病原菌132株,其中革兰阴性菌97株(73.48%);感染组患者FEV1、FVC、PEF均低于非感染组(P<0.05),PMBCs中IL-12、IL-15及ISG15 mRNA水平均高于非感染组(P<0.05);预后不良组IL-12、IL-15及ISG15 mRNA均高于预后良好组(P<0.05);IL-12、IL-15及ISG15预测老年冠心病并发肺部感染患者预后不良的AUC分别为0.642、0.728和0.768,三者联合预测预后不良的AUC分别大于IL-12(Z=3.576,P<0.001)、IL-15(Z=2.770,P=0.006)。结论 外周血单核细胞中IL-12、IL-15及ISG15表达水平在老年冠心病并发肺部感染患者明显上调,此三者联合检测对患者的预后评估具有较好的应用价值。

OBJECTIVE To detect the expression levels of interleukin-12(IL-12), interleukin-15(IL-15) and interferon stimulating gene 15(ISG15) in peripheral blood monocytes(PBMC) of the elderly coronary heart disease patients complicated with pulmonary infection and observe the association with prognosis. METHODS A total of 213 elderly patients with coronary heart disease who were treated in Zhuji Hospital of Traditional Chinese Medicine from Nov 2018 to Oct 2020 were enrolled in the study and divided into the infection group with 115 cases and the non-infection group with 98 cases. The forced expiratory volume in 1 second(FEV1), forced vital capacity(FVC) and peak expiratory flow(PEF) of the two groups of patients were recorded after the admission. The clinical values of PBMC IL-12, IL-15 and ISG15 in assessment of prognosis of the elderly coronary heart disease patients complicated with pulmonary infection were evaluated by means of receiver operating characteristic(ROC) curve. RESULTS Totally 132 strains of pathogens were isolated from the 115 elderly coronary heart disease patients complicated with pulmonary infection, 97(73.48%) of which were gram-negative bacteria. The FEV1, FVC and PEF of the infection group were significantly lower than those of the non-infection group(P<0.05);the levels of IL-12, IL-15 and ISG15 mRNA in PMBCs were significantly higher in the infection group than in the non-infection group(P<0.05);the levels of IL-12, IL-15 and ISG15 mRNA of the poor prognosis group were significantly higher than those of the good prognosis group(P<0.05). The AUCs of IL-12, IL-15 and ISG15 were respectively 0.642, 0.728 and 0.768 in prediction of poor prognosis of the elderly coronary heart disease patients complicated with pulmonary infection, the AUC of the joint detection of the three indexes was significantly greater than that of the IL-12(Z=3.576,P<0.001) and IL-15(Z=2.770,P=0.006) in prediction of poor prognosis. CONCLUSION The expression levels of PBMC IL-12, IL-15 and ISG15 are significantly up-regulated in the elderly coronary heart disease patients complicated with pulmonary infection, and the joint detection of the three indexes has high value in assessment of the prognosis.