艰难梭菌感染者血清CCL7的表达及意义研究

Study of expression and significance of CCL7 in serum in Clostridium difficile patients

目的:分析单核细胞趋化因子配体7(CCL7)在艰难梭菌感染(CDI)患者血清中的表达及意义。方法:回顾性统计分析重庆医科大学附属第一医院2018年10月至2021年6月所有艰难梭菌相关性检测项目的检出阳性率及送检科室分布情况,以及2020年7月至2021年8月确诊CDI的58例住院患者病历资料(CDI组),以25例健康体检人群作为对照(健康对照组)。ELISA检测血清CCL7水平;化学发光法检测血清TNF-α、IL-1β、IL-2R、IL-6、IL-8和IL-10水平;采用受试者工作特征(ROC)曲线评价CCL7和多种临床指标单独和联合检测在CDI诊断中的预测价值;将CDI组与健康对照组比较差异具有统计学意义的临床指标WBC、Neu、Mon、BUN、ALT和CRP与血清CCL7水平进行相关性分析。结果:CDI患者血清CCL7水平明显高于健康对照组(P<0.0001)。CDI组WBC、Neu、Mon、BUN、ALT、CRP水平高于健康对照组(P<0.05),且CDI中CCL7升高与WBC(r=0.4736,P=0.0225)和Neu(r=0.4482,P=0.0329)存在相关性,而RBC、Hb、Lym、TP、Alb水平低于健康对照组(P均<0.001)。与健康对照组相比,CDI组血清TNF-α、IL-6、IL-8、IL-10水平明显升高(P<0.05)。ROC结果表明,CCL7联合WBC、Neu、Mon、BUN、Lym、ALT可有效提高以上指标的诊断性能(P均<0.001)。相关性分析结果显示CCL7血清水平与以上有差异的临床指标和炎症因子间无明显相关性(P>0.05)。结论:CDI患者血清CCL7表达水平升高,且与WBC、Neu存在相关性,发生CDI后CCL7可能介导了炎症细胞趋化,与机体炎症进展有关。

Objective:To investigate expression and significance of monocyte chemokine ligand 7(CCL7)in patients'serum with Clostridium difficile infection(CDI).Methods:A retrospective statistical analysis was performed to analyze positive rate of C.difficile-related toxin tests and distribution of department in The First Affiliated Hospital of Chongqing Medical University form October 2018 to June 2021,and medical records of 58 hospitalized patients that confirmed CDI were recruited from July 2020 to August 2021(CDI group).At the same time,25 healthy populations were as controls(healthy control group).ELISA was used to detect the expres-sion of serum CCL7.Expressions of serum TNF-α,IL-1β,IL-2R,IL-6,IL-8 and IL-10 were detected by chemiluminescence method.Receiver operating curve(ROC)was used to evaluate the predictive value of CCL7 and other indicators in clinical diagnosis of CDI.Correlation analysis of clinical indexes WBC,Neu,Mon,BUN,ALT and CRP with serum CCL7 levels were conducted between CDI group and healthy control group.Results:Serum CCL7 level in CDI patients were higher than those of healthy control group(P<0.0001).Levels of WBC,Neu,Mon,BUN,ALT and CRP in CDI group were higher than those of control group(P<0.05),and the increase of CCL7 in CDI was correlated with WBC(r=0.4736,P=0.0225)and Neu(r=0.4482,P=0.0329),while levels of RBC,Hb,Lym,TP and Alb were lower than those of control group(P<0.001).Compared with healthy control group,serum levels of TNF-α,IL-6,IL-8 and IL-10 in CDI group were significantly higher,and the difference was statistically significant(P<0.05).ROC results showed that CCL7 combined with WBC,Neu,Mon,BUN,Lym,ALT could effectively improve diagnostic performance of these indicators(P<0.001).Results of correlation analysis showed that there was no significant correlation between CCL7 serum levels and the above clini cal indicators and inflammatory factors(P>0.05).Conclusion:Expression level of serum CCL7 in CDI patients is significantly in-creased,and is related to WBC and Neu.CCL7 may mediates the chemotaxis of inflammatory cells after CDI,which relates to progres-sion of inflammation after CDI.