摘要
目的探讨脓毒血症患者外周血中单核细胞型髓系来源抑制性细胞(monocytic myeloid-derived suppressor cells,M-MDSC)的表达水平对脓毒血症患者疾病状态和预后的评估作用。方法收集2020年1月至2022年1月于合肥市第八人民医院诊治的63例脓毒血症患者以及30例健康志愿者分别作为实验组和对照组,全自动生化分析仪检测外周血C-反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitoni,PCT)和白细胞介素(interleukin,IL)-6水平;酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测粒细胞巨噬细胞刺激因子(granulocyte-macrophage colony-stimulating factor,GM-CSF)水平;流式细胞术检测M-MDSC的表达水平,分析脓毒血症治疗前后和不同预后患者M-MDSC表达水平差异。结果与对照组比较,脓毒血症患者CRP、PCT、IL-6和GM-CSF的表达水平均明显升高,差异均具有统计学意义[ng/mL:(76.23±13.38)比(5.36±2.19),pg/mL:(182.43±37.45)比(22.56±12.35),ng/mL:(122.31±21.65)比(6.31±3.65),pg/mL:(251.85±56.78)比(28.85±6.78),t值分别为27.96,36.85,26.12,26.55,P值均<0.05]。脓毒血症患者M-MDSC的表达水平比对照组亦显著升高,差异具有统计学意义[(35.56±13.75)%比(7.47±5.23)%,t=9.38,P<0.05]。死亡脓毒血症患者M-MDSC表达显著高于好转患者,差异具有统计学意义[(47.62±6.75)%比(28.71±15.61)%,t=6.34,P<0.05]。脓毒血症患者经治疗后,M-MDSC、CRP、PCT、IL-6和GM-CSF的表达水平均显著下降,差异具有统计学意义[%:(35.56±13.75)比(19.26±12.66)%,ng/mL:(68.14±11.32)比(8.32±3.12),pg/mL:(132.41±22.48)比(31.16±11.32),ng/mL:(110.86±15.68)比(9.51±3.12),pg/mL:(196.86±37.15)比(22.87±7.71),t值分别为26.77,30.70,8.36,40.55,42.45,P值均<0.05]。结论M-MDSC能够及时反应脓毒血症患者感染程度和免疫功能状态,通过监测M-MDSC的水平,可以更加客观精准的评估脓毒血症患者病情炎症状态及预后。
Objective To investigate the role of monocytic myeloid-derived suppressor cells(M-MDSC)expression in peripheral blood of patients with sepsis in the evaluation of disease status and prognosis.Methods A total of 63 patients with sepsis and 30 healthy volunteers admitted to the Eighth People's Hospital of Hefei from January 2020 to January 2022 were collected as exprimenal group and control group.Automatic biochemical analyzer was used to detect C-reactive protein(CRP),procalcitonin(PCT)and interleukin(IL)-6 levels.Enzyme linked immunosorbent assay(ELISA)to detect the level of granulocyte-macrophage colony-stimulating factor(GM-CSF).The expression of M-MDSC was detected by flow cytometry,and the difference of M-MDSC expression was analyzed before and after treatment and in different prognostic groups.Results Compared with the control group,the expression levels of CRP,PCT,IL-6 and GM-CSF in sepsis patients were significantly increased,and the differences were statistically significant[ng/mL:(76.23±13.38 vs(5.36±2.19),pg/mL:(182.43±37.45)vs(22.56±12.35),ng/mL:(122.31±21.65)vs(6.31±3.65),pg/mL:(251.85±56.78)vs(28.85±6.78),t values were 27.96,36.85,26.12,26.55 respectively,all P values<0.05].The expression of M-MDSC in sepsis patients was also significantly higher than that in control group,the difference was statistically significant[(35.56±13.75)%vs(7.47±5.23)%,t=9.38,P<0.05].The expression of M-MDSC in sepsis patients in death group was significantly higher than that in improvement group,and the difference was statistically significant[(47.62±6.75)%vs(28.71±15.61)%,t=6.34,P<0.05].After treatment,the expression levels of M-MDSC,CRP,PCT,IL-6 and GM-CSF were significantly decreased in patients with sepsis,and the difference was statistically significant[ng/mL:(68.14±11.32)vs(8.32±3.12),pg/mL:(132.41±22.48)vs(31.16±11.32),ng/mL:(110.86±15.68)vs(9.51±3.12),pg/mL:(196.86±37.15)vs(22.87±7.71),t value were 26.77,30.70,8.36,40.55,42.45 respectively,all P values are<0.05].Conclusion M-MDSC may effectively reflect the degree of infection and immune function status of patients with sepsis the condition and prognosis of patients with sepsis can be more objectively assessed by monitoring the level of M-MDSC.
作者
徐海保
储成龙
Xu Haibao;Chu Chenglong(Department of Intensive Care Unit,Hefei Eighth People's Hospital,Hefei 230011,China)
出处
《国际免疫学杂志》
CAS
2023年第2期134-138,共5页
International Journal of Immunology
基金
安徽省自然科学基金(2008085QH372)。
关键词
脓毒血症
单核细胞型髓系来源抑制性细胞
疗效
预后
Sepsis
monocytic myeloid-derived suppressor cells
Treatment outmentoutcome
Prognosis
