Sun Lifang, Liu Yu
Department of Blood Transfusion, Tianshui First People's Hospital, Tianshui, Gansu 741000, China.
Department of Laboratory, Tianshui First People's Hospital, Tianshui, Gansu 741000, China.
Emerg Med Int. 2022 May 27;2022:7344375. doi: 10.1155/2022/7344375. eCollection 2022.
Analysis of clinical factors and changes in regulatory T cell (Treg)-related cytokine levels in transfusion-associated acute lung injury (TRALI).
62 patients who underwent blood transfusion and developed TRALI (TRALI group) in our hospital between January 2018 and December 2021 and 58 patients who did not develop TRALI (non-TRALI group) from blood transfusion were selected to collect clinical data from patients and construct a logistic regression model to analyze clinical risk factors for TRALI. Based on the prognosis of TRALI patients, they were divided into survival group (50 cases) and death group (12 cases), and serum CD4 + CD25 + Treg and Treg-related cytokines (interleukin 10 (IL-10), transforming growth factor- (TGF-)) levels were compared between the two groups, and the correlation between CD4 + CD25 + Treg and IL-10 and TGF- was analyzed by Pearson.
The differences in smoking history, human leukocyte antigen (HLA) antibody II, pretransfusion shock, and CD4 + CD25 + Treg between the TRALI group and non-TRALI group were statistically significant ( < 0.05). Logistic regression analysis showed that HLA antibody II and increased CD4 + CD25 + Treg were independent risk factors of TRALI ( < 0.05). The levels of CD4 + CD25 + Treg, IL-10, and TGF- in the death group were significantly higher than those in the survival group ( < 0.05). CD4 + CD25 + Treg was positively correlated with levels of IL-10 and TGF- ( < 0.05).
Elevated HLA antibody II and CD4 + CD25 + Treg are the main clinical risk factors for TRALI, and CD4 + CD25 + Treg may be involved in immunosuppression by increasing the expression levels of IL-10 and TGF-. Early clinical monitoring of changes in Treg-related cytokine levels can provide some guidance for prognostic assessment of TRALI patients.
分析输血相关急性肺损伤（TRALI）的临床因素及调节性T细胞（Treg）相关细胞因子水平的变化。
选取2018年1月至2021年12月在我院接受输血并发生TRALI的62例患者（TRALI组）和58例未发生TRALI的输血患者（非TRALI组），收集患者临床资料，构建logistic回归模型分析TRALI的临床危险因素。根据TRALI患者的预后情况，将其分为存活组（50例）和死亡组（12例），比较两组血清CD4 + CD25 + Treg及Treg相关细胞因子（白细胞介素10（IL-10）、转化生长因子-（TGF-））水平，并采用Pearson法分析CD4 + CD25 + Treg与IL-10和TGF-的相关性。
TRALI组与非TRALI组在吸烟史、人类白细胞抗原（HLA）抗体II、输血前休克及CD4 + CD25 + Treg方面差异有统计学意义（<0.05）。logistic回归分析显示，HLA抗体II及CD4 + CD25 + Treg升高是TRALI的独立危险因素（<0.05）。死亡组CD4 + CD25 + Treg、IL-10及TGF-水平显著高于存活组（<0.05）。CD4 + CD25 + Treg与IL-10和TGF-水平呈正相关（<0.05）。
HLA抗体II升高及CD4 + CD25 + Treg是TRALI的主要临床危险因素，CD4 + CD25 + Treg可能通过增加IL-10和TGF-表达水平参与免疫抑制。早期临床监测Treg相关细胞因子水平变化可为TRALI患者的预后评估提供一定指导。
