| 李 智,王 晴,吴苏明,许晓函,权钰迪,祝 旺.血清炎症因子联合T淋巴细胞亚群在急性呼吸窘迫综合征中的应用价值分析[J].,2023,(15):2985-2989 |
| 血清炎症因子联合T淋巴细胞亚群在急性呼吸窘迫综合征中的应用价值分析 |
| Application Value of Serum Inflammatory Cytokines Combined with T Lymphocyte Subsets in Acute Respiratory Distress Syndrome |
| 投稿时间：2023-02-10 修订日期：2023-02-28 |
| DOI：10.13241/j.cnki.pmb.2023.15.036 |
| 中文关键词: 急性呼吸窘迫综合征 炎症因子 T淋巴细胞亚群 |
| 英文关键词: Acute respiratory distress syndrome Inflammatory cytokines T lymphocyte subsets |
| 基金项目:江苏省自然科学基金青年科技人才专项（2019-2712） |
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| 中文摘要: |
| 摘要 目的：分析血清炎症因子联合T淋巴细胞亚群在急性呼吸窘迫综合征中的应用价值。方法：选择我院2021年7月至2022年12月收治的70例急性呼吸窘迫综合征患者作为研究对象，分为轻度组、中度组和重度组。检测所有入选者的血清炎症因子、T淋巴细胞亚群，分析急性呼吸窘迫综合征患者血清炎症因子、T淋巴细胞亚群与氧合指数（OI）、肺部超声B线数目的关系；观察急性呼吸窘迫综合征患者28 d后预后情况，分为死亡组与存活组，使用ROC曲线分析血清炎症因子联合T淋巴细胞亚群对急性呼吸窘迫综合征患者死亡的预测效能。结果：血清IL-6、IFN-γ表达水平、外周血Th17细胞比例、Th17/Treg比值在轻度组、中度组和重度组中差异显著，两两比较，差异显著（P＜0.05）；经Pearson相关性分析，急性呼吸窘迫综合征患者血清IL-6、IFN-γ表达水平、外周血Th17细胞比例、Th17/Treg比值均与OI呈负相关，与B线数目呈正相关（P＜0.05）；死亡组血清IL-6、IFN-γ表达水平、外周血Th17细胞比例均高于存活组，Th17/Treg比值大于存活组，差异显著（P＜0.05）；经ROC曲线分析，IL-6、IFN-γ联合Th17/Treg比值预测急性呼吸窘迫综合征患者死亡的AUC为0.935。结论：血清炎症因子、T淋巴细胞亚群与急性呼吸窘迫综合征病情严重程度有关，其中IL-6、IFN-γ联合Th17/Treg比值预测预后不良的效能较好，值得临床予以重视应用。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the application value of serum inflammatory cytokines combined with T lymphocyte subsets in acute respiratory distress syndrome. Methods: 70 ARDS patients admitted to our hospital from July 2021 to December 2022 were selected as research subjects and divided into mild, moderate and severe groups. Serum inflammatory factors and T lymphocyte subsets of all selected patients were detected, and the relationship between serum inflammatory factors and T lymphocyte subsets and oxygenation index (OI) and Number of B line of lung ultrasonography in patients with acute respiratory distress syndrome was analyzed. The prognosis of patients with acute respiratory distress syndrome after 28 days was observed and divided into death group and survival group. The predictive efficacy of serum inflammatory factors combined with T lymphocyte subsets on death of patients with acute respiratory distress syndrome was analyzed by ROC. Results: The expression levels of interleukin-6 (IL-6), interferon-γ (IFN-γ) and Th17 cells in peripheral blood in the observation group were higher than those in the control group, and the Th17/Treg ratio was higher than that in the control group (P<0.05). There was no significant difference in the proportion of Treg cells in peripheral blood between the two groups (P>0.05). There were significant differences in serum IL-6, IFN-γ expression levels, Th17 cell proportion in peripheral blood and Th17/Treg ratio in mild, moderate and severe groups,and pairwise comparison showed significant differences (P<0.05). According to Pearson correlation analysis, the serum IL-6 and IFN-γ expression levels, Th17 cell ratio and Th17/Treg ratio in peripheral blood of patients with acute respiratory distress syndrome were negatively correlated with OI (P<0.05), but positively correlated with Number of B line (P<0.05). The expression levels of IL-6, IFN-γ in serum and Th17 cells in peripheral blood in death group were higher than those in survival group, and the Th17/Treg ratio was higher than that in survival group (P<0.05). According to ROC curve analysis, the AUC of IL-6, IFN-γ combined with Th17/Treg ratio to predict death in patients with ARDS was 0.935. Conclusion: Serum inflammatory cytokines and T lymphocyte subsets are related to the severity of acute respiratory distress syndrome, and IL-6, IFN-γ combined with Th17/Treg ratio can predict poor prognosis,which is worthy of clinical attention. |
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