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[外周血中白细胞介素-6、白细胞介素-1β和白细胞介素-10水平作为革兰氏阳性和革兰氏阴性脓毒症早期识别指标]

[IL-6, IL-1β, and IL-10 levels in peripheral blood as indicators for early identification of gram-positive and gram-negative sepsis].

作者信息

Hu Shanbo, Yang Jing, Yu Chaoping, Feng Zhusheng, Zhang Jinxin, Yin Wen, Xie Jiangang

机构信息

Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an 710032, China.

Department of Emergency, Xijing Hospital, Air Force Medical University, Xi'an 710032, China. *Corresponding authors, E-mail:

出版信息

Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2021 Jun;37(6):532-537.

Abstract

Objective To find out indicators for rapid identification of Gram-positive (G) and Gram-negative (G) bacteria through transcriptome sequencing of peripheral blood mononuclear cells (PBMCs) and serum liquid-phase chip technology in early sepsis. Methods 35 eligible cases out of 182 sepsis patients in the emergency intensive care unit (EICU) were selected for retrospective analysis. They were divided into G group (12 cases) and G group (23 cases) based on their blood culture results. General characteristics like patients' age, gender, sequential organ failure assessment (SOFA) scores, etc. and other laboratory indexes such as blood routine, IL-6, CRP, procalcitonin(PCT)of these two groups were analyzed. PBMCs were isolated through single density gradient centrifugation. Total RNA was extracted for transcriptome sequencing to find out differential genes. Serum liquid-phase chip technology was performed to detect serum granulocyte colony stimulating factor (G-CSF), granulocyte-macrophage colony stimulating factor (GM-CSF), IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, monocytes chemotactic protein 1 (MCP-1), tumor necrosis factor alpha (TNF-α) in two groups. Receiver operating characteristic (ROC) curve was drawn using bacteria types as a dependent variable and selected cytokines as test variables, to analyze the correlation between selected biomarkers and bacteria type. Results No significant difference in general characteristics, CRP, and PCT were found between the G and G group. The serum level of IL-6 in G group was lower than that in the G group. Transcriptome sequencing results revealed 30 immune-related genes that were differentially expressed in the PBMCs of two groups. Compared to the G group, the serum levels of IL-6 and IL-1β in G group significantly increased, while serum IL-10 was reduced. ROC curve analysis indicated that serum IL-6, IL-1β, and IL-10 levels could identify the G and G bacteria types. The combined diagnosis using these three indicators is highly applicable in distinguishing G and G bacteria. Conclusion IL-6, IL-1β and IL-10 levels can be used as indicators for early identification of sepsis induced by G or G bacteria.

摘要

目的 通过对早期脓毒症患者外周血单个核细胞(PBMCs)进行转录组测序及血清液相芯片技术,找出快速鉴定革兰氏阳性(G⁺)菌和革兰氏阴性(G⁻)菌的指标。方法 选取急诊重症监护病房(EICU)182例脓毒症患者中的35例符合条件的病例进行回顾性分析。根据血培养结果将其分为G⁺组(12例)和G⁻组(23例)。分析两组患者的年龄、性别、序贯器官衰竭评估(SOFA)评分等一般特征以及血常规、IL-6、CRP、降钙素原(PCT)等其他实验室指标。通过单密度梯度离心法分离PBMCs。提取总RNA进行转录组测序以找出差异基因。采用血清液相芯片技术检测两组血清中的粒细胞集落刺激因子(G-CSF)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、IFN-γ、IL-1β、IL-2、IL-4、IL-5、IL-6、IL-7、IL-8、IL-10、IL-12、IL-13、IL-17、单核细胞趋化蛋白1(MCP-1)、肿瘤坏死因子α(TNF-α)。以细菌类型为因变量,选取的细胞因子为检验变量绘制受试者工作特征(ROC)曲线,分析所选生物标志物与细菌类型之间的相关性。结果 G⁺组和G⁻组在一般特征、CRP和PCT方面无显著差异。G⁺组血清IL-6水平低于G⁻组。转录组测序结果显示两组PBMCs中有30个免疫相关基因差异表达。与G⁻组相比,G⁺组血清IL-6和IL-1β水平显著升高,而血清IL-10降低。ROC曲线分析表明血清IL-6、IL-1β和IL-10水平可鉴别G⁺菌和G⁻菌类型。使用这三个指标进行联合诊断在区分G⁺菌和G⁻菌方面具有很高的适用性。结论 IL-6、IL-1β和IL-

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