外周血Th22在脓毒症患者中的水平变化及临床意义

目的 探讨外周血T h22在脓毒症患者中的水平变化及其临床意义.方法 选取2014年4月至2017年4月在该院就诊的脓毒症患者180例为研究对象,根据病情严重程度将其分为普通脓毒症组81例、严重脓毒症组68例和脓毒症休克组31例,另选取60例健康体检者为对照.检测各组外周血T h22、白细胞介素(IL)-22、IL-6及降钙素原(PC T)水平,记录急性生理与慢性健康状况(APACHEⅡ)评分情况,采用受试者工作特征(ROC)曲线评估外周血Th22对脓毒症早期诊断的价值.结果 脓毒症患者外周血T h22和IL-22水平明显高于对照组(P<0.05).普通脓毒症组、严重脓毒症组及脓毒症休克组患者外周血Th22、IL-22、APACHEⅡ评分及PCT水平比较,差异有统计学意义(P<0.05).相关性分析显示,外周血Th22与PCT、A-PACHEⅡ评分呈正相关(r=0.80、0.66,P<0.01).外周血Th22=1.9%时,其敏感性和特异性分别为83.1%和85.2%,明显优于PC T.结论 外周血T h22及其相关细胞因子对脓毒症患者早期诊断及病情严重程度的评估具有重要的临床价值.

Changes and significance of peripheral blood Th22 level in patients with sepsis

Objective To investigate the change of peripheral blood Th22 cells level in the patients with sepsis and its clinical significance .Methods A total of 180 patients with sepsis in this hospital from April 2014 to April 2017 were selected as the re-search subjects and divided into the common sepsis group (81 cases) ,severe sepsis group (68 cases) and septic shock group (31 ca-ses) according to the sepsis severity .The levels of IL-22 ,IL-6 and PCT in peripheral blood Th22 cells were measured in each group .The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores were recorded .The efficiency of peripheral blood Th22 cells in the early diagnosis of sepsis was evaluated by adopting the receiver operating characteristic (ROC) curve .Results The levels of peripheral blood Th22 cells and IL-22 in the patients with sepsis were significantly than those in the control group (P<0 .05) .The levels of Th22 cells ,IL-22 and PCT and APACHE Ⅱ scores had statistical differences among the common sepsis group ,severe sepsis group and septic shock group (P<0 .05) .The correlation analysis showed that peripheral blood Th22 cells lev-el was positively correlated with PCT level and APACHE Ⅱ scores respectively (r=0 .80 ,0 .66 ,P<0 .01) .With peripheral blood Th22 cells level=1 .9% as the boundary for early diagnosis of sepsis ,its sensitivity and specificity were 83 .1% and 85 .2% respec-tively ,which was significantly better than the PCT index .Conclusion Peripheral blood Th22 cells and related cytokines have the important clinical application value for the early diagnosis of sepsis and assessment of disease severity .