摘要
目的探讨新型冠状病毒肺炎(简称“新冠”肺炎)患者血浆细胞因子和肠道菌群检测的临床应用价值,为新冠肺炎患者的临床治疗提供参考依据。方法选取新冠肺炎患者35例(轻症25例、重症10例)作为观察组,健康体检者30例作为对照组,收集两组对象的血浆和肠道分泌物分别进行检测和分离培养。采用流式细胞仪检测血浆细胞因子水平,飞行质谱仪鉴定肠道分泌物的细菌种类,比较各型新冠肺炎患者血浆细胞因子的差异性表达,分析细胞因子水平与肠道细菌的关联性。结果新冠肺炎患者血浆白细胞介素(IL)-2、IL-4、IL-10、肿瘤坏死因子-α(TNF-α)水平分别为(4.7±0.9)、(10.5±1.3)、(5.7±0.3)、(2.9±1.1)pg/mL,对照组分别为(2.7±0.5)、(4.7±0.6)、(2.7±0.4)、(1.0±0.2)pg/mL,差异有统计学意义(P<0.05)。重症新冠肺炎患者血浆IL-2、IL-4、IL-10水平高于轻症患者,差异有统计学意义(P<0.05)。新冠肺炎患者肠道分泌物检出较多拟杆菌、棒状杆菌、肠梭菌、肠球菌和链球菌等,而对照组肠道分泌物仅检出梭杆菌、粪肠球菌、粪球菌等。新冠肺炎患者肠道血浆IL-4、IL-6、IL-10和TNF-α水平与肠道乳酸杆菌、双歧杆菌呈正相关,而与拟杆菌和链球菌呈负相关。结论新冠肺炎患者血浆细胞因子水平升高,随病情轻重呈差异性表达,且与肠道菌群分布密切相关,可为患者的临床治疗提供重要参考依据,具有重要的临床应用价值。
Objective To explore the clinical application value of plasma cytokines and intestinal flora detection in patients with COVID-19,and provide reference for clinical treatment of patients with COVID-19.Methods Thirty-five COVID-19 patients(25 mild cases and 10 severe cases)were selected as the observation group,and 30 healthy people were selected as the control group.Plasma and intestinal secretions of the two groups were collected for detection,isolation and culture.Plasma cytokine groups were collected for detection,isolation and culture.Plasma cytokine levels were detected by flow cytometry,and bacterial species in intestinal secretions were identified by flight mass spectrometer.The differential expression of plasma cytokines in patients with different types of COVID-19 was compared,and the correlation between cytokine levels and intestinal bacteria was analyzed.Results Plasma levels of IL-2,IL-4,IL-10 and TNF-αin patients with COVID-19 were(4.7±0.9),(10.5±1.3),(5.7±0.3)and(2.9±1.1)pg/mL,and(2.7±0.5),(4.7±0.6),(2.7±0.4),(1.0±0.2)pg/mL in control group,respectively.The difference was statistically significant(P<0.05).The levels of IL-2,IL-4 and IL-10 in patients with severe COVID-19 were significantly higher than those in patients with mild COVID-19(P<0.05).More Bacteroides,corynebacterium,clostridium intestinalis,enterococcus and streptococcus were detected in the intestinal secretions of patients with COVID-19,while only clostridium,enterococcus faecalis and faecalis were detected in the intestinal secretions of the control group.The levels of IL-4,IL-6,IL-10 and TNF-αin the intestinal plasma of patients with COVID-19 were positively correlated with intestinal lactobacillus and bifidobacterium,but negatively correlated with bacteroides and streptococcus.Conclusion The level of plasma cytokines in patients with COVID-19 is increased,and the expression is different with the severity of the disease,and it is closely related to the distribution of intestinal flora,which can provide an important reference
作者
夏兴焕
徐俪菲
张鹏飞
周保成
XIA Xinghuan;XU Lifei;ZHANG Pengfei;ZHOU Baocheng(Department of Laboratory,Lianyungang Maternal and Child Health Hospital,Lianyungang,Jiangsu 222000,China)
出处
《检验医学与临床》
2023年第S02期89-92,共4页
Laboratory Medicine and Clinic
