血清CD40L、VCAM-1表达与儿童细菌性肺炎严重程度的相关性

Correlation between serum CD40L and VCAM-1 expression and severity of bacterial pneumonia in children

目的探讨血清中肿瘤坏死因子相关激活蛋白(CD40 ligand, CD40L)及血管细胞黏附分子-1(vascular cell adhesion molecule 1, VCAM-1)表达水平与儿童细菌性肺炎严重程度的相关性。方法选择56例儿童细菌性肺炎患者作为观察组,再根据患儿的病情严重程度分为重症肺炎(26例)及非重症肺炎(30例)两个亚组;同期正常体检的儿童36例作为对照组。两组儿童的血清CD40L、VCAM-1表达水平与炎性因子白细胞介素-6(interleukin 6, IL-6)、白细胞介素-8(interleukin 8, IL-8)和肿瘤坏死因子-α(tumor necrosis factorα, TNF-α)表达水平均应用ELISA法检测,外周血T细胞亚群CD4^+、CD8^+以及CD4^+/CD8^+表达水平均应用流式细胞法检测。观察不同组间儿童血清中CD40L、VCAM-1、T细胞亚群、炎症因子表达水平变化,以及上述指标与疾病严重程度的相关性。结果观察组患者血清CD40L和VCAM-1表达水平分别为(2.73±0.68) ng/mL和(624.34±179.65) ng/mL,对照组分别为(2.14±0.78) ng/mL和(467.87±109.91) ng/mL,两组差异有统计学意义(P<0.05);血清CD40L和VCAM-1表达水平重症肺炎组[(2.91±0.68) ng/mL、(656.34±178.09) ng/mL]与非重症肺炎组[(2.50±0.71) ng/mL和(574.47±143.91) ng/mL]差异有统计学意义(P<0.05);并且外周血淋巴细胞的CD4^+、CD8^+、CD4^+/CD8^+细胞,血清IL-6、TNF-α、IL-8指标,重症肺炎组与非重症肺炎组间差异有统计学意义(P<0.05)。结论儿童感染细菌性肺炎后血清CD40L、VCAM-1等指标表达水平会显著上升,且表达变化与病情严重程度呈正相关,通过检测CD40L、VCAM-1等指标水平有助于判断病情转归情况。

Objective To investigate the correlation between serum CD40 L and VCAM-1 expression levels and the severity of bacterial pneumonia in children.Methods Fifty-six children with bacterial pneumonia were selected as the study group.According to the severity of the disease,the children were divided into two subgroups,severe(26 cases)and non-severe(30 cases).Thirty-six children with normal physical examination during the same period were served as control group.The expression levels of serum CD40 L and VCAM-1,and the expression levels of inflammatory factors IL-6,TNF-αand IL-8 were assessed by ELISA;while peripheral blood T cell subsets CD4^+,CD8^+and CD4^+/CD8^+expression levels were assessed by flow cytometry.The changes of CD40 L,VCAM-1,T cell subsets and inflammatory factors in serum of children from different groups were observed,and the correlation between these indicators and disease severity was observed.Results The serum levels of CD40 L and VCAM-1 in the study group were 2.73±0.68 ng/mL and 624.34±179.65 ng/mL,respectively;and in the control group were 2.14±0.78 ng/mL and 467.87±109.91 ng/mL,respectively.The difference between the two groups was significant(P<0.05).Serum CD40 L and VCAM-1 expression levels were also significantly different between the severe group(2.91±0.6 ng/mL and 656.34±178.09 ng/mL)and the non-severe group(2.50±0.71 ng/mL and 574.47±143.91 ng/mL)(P<0.05);and so were the peripheral blood lymphocytes CD4^+,CD8^+,CD4^+/CD8^+cells,serum interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)indicators(P<0.05).Conclusion The expression levels of serum CD40 L and VCAM-1 in children with bacterial pneumonia are significantly increased.And the expression is positively correlated with the severity of the disease.