维持性血液透析患者白介素和免疫球蛋白水平与透析导管相关性感染及预后的关联性

Association of Interleukins and Immunoglobulins Levels with Catheter-associated Infection and Prognosis in Patients on Maintenance Hemodialysis

目的分析维持性血液透析(maintenance hemodialysis,MHD)患者白介素-6(interleukin-6,IL-6)、白介素-1β(interleukin-1β,IL-1β)和免疫球蛋白IgA、IgM、IgG与透析导管相关性感染及预后的关联性。方法经医院伦理学批准,选择医院2019年7月1日至2021年7月1日诊治的MHD患者80例。检测血清IL-6、IL-1β和免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白M(immunoglobulin M,IgM)、免疫球蛋白G(immunoglobuling,IgG)水平,统计透析导管相关性感染及预后情况。比较透析导管相关性感染患者及非感染患者的血清IL-6、IL-1β和IgA、IgM、IgG水平,分析不同预后患者血清IL-6、IL-1β和IgA、IgM、IgG水平,探讨其相关性。结果感染组患者血清IL-6(58.26±3.06)ng/L、IL-1β(44.26±2.05)ng/L高于非感染组患者(P<0.05)。感染组患者血清IgA(0.89±0.12)g/L、IgM(1.13±0.14)g/L、IgG(9.36±0.21)g/L低于非感染组(P<0.05)。预后良好的患者血清IL-6(32.41±4.26)ng/L、IL-1β(21.69±1.26)ng/L低于预后不良患者(P<0.05)。预后不良患者血清IgA(1.84±0.14)ng/L、IgM(1.92±0.14)ng/L、IgG(13.98±0.21)ng/L低于预后良患者(P<0.05)。血清IL-6、IL-1β水平与透析导管相关性感染发生呈正相关(P<0.05),与预后呈负相关(P<0.05)。IgA、IgM、IgG水平与透析导管相关性感染发生呈负相关(P<0.05),与预后呈正相关(P<0.05)。结论MHD患者血清IL-6、IL-1β及IgA、IgM、IgG水平影响透析导管相关性感染及预后,其中血清IL-6、IL-1β水平高表达,而IgA、IgM、IgG水平低表达直接影响透析导管相关性感染及预后。

Objective To investigate the association of interleukin-6(IL-6),interleukin-1β(IL-1β)and immunoglobulin A(IgA),IgM and IgG levels with catheter-associated infection and prognosis in patients on maintenance hemodialysis(MHD).Methods With the approval of hospital committee,80patients on MHD in our hospital from July 1,2019to July 1,2021were selected.Serum IL-6,IL-1β,IgA,IgM and IgG levels were detected,and dialysis catheter-associated infection and prognosis were analyzed in all patients.Then comparison of serum IL-6,IL-1β,IgA,IgM and IgG levels was performed among patients of different infection and prognosis status.Thereafter,the correlation of interleukins and immunoglobulins levels with catheter-associated infection and prognosis was discussed.Results Compared with those without infection,patients with infection had significantly higher serum IL-6(58.26±3.06)ng/L and IL-1β(44.26±2.05)ng/L,with statistical difference(P<0.05).Serum IgA,IgM and IgG were(0.89±0.12)g/L,(1.13±0.14)g/L and(9.36±0.21)g/L in patients with infection,and were lower than those of non-infected patients(P<0.05).Serum IL-6and IL-1βof patients with good prognosis were(32.41±4.26)ng/L and(21.69±1.26)ng/L,and were significantly lower than those with poor prognosis(P<0.05).Serum IgA,IgM and IgG in patients with good prognosis were(1.84±0.14)ng/L,(1.92±0.14)ng/L and(13.98±0.21)ng/L,which were significantly higher than those with poor prognosis(P<0.05).Serum IL-6and IL-1βlevels were positively correlated with dialysis catheter-associated infections(P<0.05),and negatively correlated with prognosis(P<0.05).The levels of IgA,IgM,and IgG were negatively correlated with the occurrence of dialysis catheter-associated infections(P<0.05),and positively correlated with the prognosis(P<0.05).Conclusion Serum IL-6,IL-1β,IgA,IgM and IgG levels in patients on MHD cause an impact on dialysis catheter-related infections and prognosis,of which the elevated serum IL-6and IL-1βlevel along with decrease IgA,IgM,and IgG levels directly affect dialysis catheter-associated infection and prognosis.