摘要
目的探究肝衰竭合并不同病原菌感染患者Th1/Th2细胞亚群细胞因子谱水平变化及其对革兰氏阳性菌、革兰氏阴性菌的鉴别价值。方法选择收治的肝衰竭合并细菌感染患者60例,其中G^(-)菌感染30例为G^(-)菌组;G^(+)菌感染30例为G^(+)菌组,选取同期肝衰竭无感染患者30例为无感染组。对各组患者检测IL-2、IL-4、IL-6、IL-10、肿瘤坏死因子(TNF-α)、干扰素-γ(IFN-γ)水平。结果G^(-)菌组、G^(+)菌组的IL-6、IL-10水平显著高于无感染组(P<0.05),G^(-)菌组IL-6和IL-10水平均高于G^(+)菌组(P<0.05);与无感染组比较,G^(-)菌、G^(+)菌组IL-2均有不同程度升高,但G^(-)菌组、G^(+)菌组无显著差异(P>0.05);G^(-)菌组的IFN-γ水平高于无感染组,但G^(+)菌组与无感染组无显著差异;IL-4、TNF-α在三组间无明显差异(P>0.05);IL-6、IL-10单独及联合检测鉴别G^(-)菌感染的曲线下面积分别为0.853、0.841、0.849,阈值为112.345 pg/mL、26.85 pg/mL时约登指数最大。结论肝衰竭合并细菌感染患者存在Th1/Th2细胞因子谱水平的失衡,其中IL-6、IL-10单独及联合检测以其较高的诊断效能在肝衰竭合并细菌感染中对早期鉴别细菌类型具有重要的参考价值。
Objectives To explore the changes on the cytokine profile of Th1/Th2 cell subsets in patients with liver failure complicated with different pathogen infections and their value in the identification of Gram-positive(G^(+))bacteria and Gram-negative(G^(-))bacteria.Methods A total of 60 patients with liver failure complicated with bacterial infection treated in the Ninth Hospital of Nanchang were selected as the observation group,including 30 cases of G^(-)bacteria infection and 30 cases of G^(+)bacteria infection.Another 30 patients with liver failure without infection in the same period were selected as the control group.The levels of IL-2,IL-4,IL-6,IL-10,tumor necrosis factor(TNF-α)and interferon-γ(IFN-γ)were detected in each group.Results The levels of IL-6 and IL-10 in G^(-)bacteria group and G^(+)bacteria group were significantly higher than those in non-infection group(P<0.05),while the levels of IL-6 and IL-10 in G^(-)bacteria group were significantly higher than those in G^(+)bacteria group(P<0.05).Compared with the non-infection group,IL-2 in G^(-)bacteria and G^(+)bacteria groups increased in varying degrees,but there was no significant difference between the two groups(P>0.05).The level of IFN-γin G^(-)bacteria group was higher than that in the control group,but there was no significant difference between G^(+)bacteria group and the control group.There was no significant difference in IL-4 and TNF-αamong the three groups(P>0.05).The areas under the curve of IL-6,IL-10 and combined detection to identify G^(-)bacteria infection were 0.853,0.841 and 0.849 respectively,and the Yoden index was the highest when the threshold was 112.345 pg/mL and 26.85 pg/mL.Conclusions There is an imbalance of Th1/Th2 cytokine profile in patients with liver failure complicated with bacterial infection,among which IL-6,IL-10 and their combined detection have important reference value for early identification of bacterial types in liver failure complicated with bacterial infection due to their high diagnostic efficacy.
作者
熊云逢
李美琦
张鑫垚
甘达凯
熊墨龙
XIONG Yunfeng;LI Meiqi;ZHANG Xinyao;GAN Daikai;XIONG Molong(The Ninth Hospital of Nanchang,Nanchang 330006,China)
出处
《现代诊断与治疗》
CAS
2023年第22期3323-3326,3382,共5页
Modern Diagnosis and Treatment
基金
江西省卫生健康委科技计划项目(项目编号202211514)。
