摘要
目的探讨中性粒细胞胞外诱捕网(NETs)激活单核细胞在急性呼吸窘迫综合征(ARDS)病情及预后评估中的价值。方法将100例ARDS患者根据氧合指数(OI)分为轻度组21例、中度组31例和重度组48例,根据28 d病死率分为存活组62例和死亡组38例;另选取体检健康者30例为对照组。检测并比较各组NETs和炎性因子[包括白介素-6(IL-6)、单核细胞趋化蛋白1(MCP-1)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白介素-1β(IL-1β)、白介素-10(IL-10)、白介素-12(IL-12)]水平;采用受试者工作特征(ROC)曲线分析NETs激活单核细胞在ARDS病情及预后评估中的意义。结果与对照组比较,ARDS患者NETs、IL-6、MCP-1、TNF-α、IFN-γ、IL-1β水平显著升高,且随着病情的加重逐渐升高,差异均有统计学意义(P<0.05);各组IL-10、IL-12水平比较差异无统计学意义(P>0.05);NETs联合炎性因子(IL-6、MCP-1、TNF-α、IFN-γ、IL-1β)检测评估ARDS病情的灵敏度、特异性、准确度分别为89.68%、92.14%、86.34%,显著高于各指标单独检测(P<0.05)。与死亡组比较,存活组NETs、IL-6、MCP-1、TNF-α、IFN-γ、IL-1β水平显著降低,差异均有统计学意义(P<0.05);2组IL-10、IL-12水平比较差异无统计学意义(P>0.05);NETs联合炎性因子(IL-6、MCP-1、TNF-α、IFN-γ、IL-1β)检测评估ARDS预后的灵敏度、特异性、准确度分别为87.42%、83.16%、85.69%,显著高于各指标单独检测(P<0.05)。结论NETs能够有效激活单核细胞并诱导其释放大量IL-6、MCP-1、TNF-α、IFN-γ、IL-1β等因子,参与ARDS疾病的进展,通过检测其水平能够有效评估ARDS患者的病情及预后,对临床诊治该病有较高的参考价值。
Objective To explore the significance of neutrophil extracellular traps(NETs)activating monocytes in the evaluation of disease severity and prognosis of acute respiratory distress syndrome(ARDS).Methods According to the oxygenation index(OI),A total of 100 acute respiratory distress syndrome(ARDS)patients were divided into the mild group(21 cases),the moderate group(31 cases)and the severe group(48 cases).According to the 28 day mortality,the patients were divided into the survival group(62 cases)and the death group(38 cases).Another 30 healthy people who underwent physical examination during the same period were established as the control group.The levels of NETs,IL-6,MCP-1,TNF-α,IFN-γ,IL-1β,IL-10 and IL-12 were measured;the receiver operator characteristiccurve(ROC)was used to analyze the significance of NETs activating monocytes in the evaluation of disease severity and prognosis of ARDS.Results Compared with the control group,the levels of NETs,IL-6,MCP-1,TNF-α,IFN-γand IL-1βwere significantly increased,and gradually increased with the aggravation of the disease,and the difference was statistically significant(P<0.05);there were no significant differences in the levels of IL-10 and IL-12 among the groups(P>0.05);the sensitivity,specificity,and accuracy of combining NETs with inflammatory factors(IL-6,MCP-1,TNF-α,IFN-γ,IL-1β)for assessing ARDS severity were 89.68%,92.14%,and 86.34%,respectively,which were significantly higher than those of individual markers(P<0.05).Compared with the death group,the levels of NETs,IL-6,MCP-1,TNF-α,IFN-γ,and IL-1βin the survivor group were significantly lower,and the differences were statistically significant(P<0.05);there was no statistically significant difference in the levels of IL-10 and IL-12 between the two groups(P>0.05);the sensitivity,specificity,and accuracy of combining NETs with inflammatory factors(IL-6,MCP-1,TNF-α,IFN-γ,IL-1β)in assessing the prognosis of ARDS were 87.42%,83.16%,and 85.69%,respectively,which were significantly higher than those of individual markers(P<0.05).Conclusion NETs can effectively activate monocytes and induce their release of large amounts of factors such as IL-6,MCP-1,TNF-α,IFN-γ,and IL-1β,which are involved in the progression of ARDS.By detecting their levels,it is possible to effectively evaluate the condition and prognosis of ARDS patients,providing reference value for clinical diagnosis and treatment of the disease.
作者
赵伊婷
张裕祥
马洁
何雪娇
ZHAO Yi-ting;ZHANG Yu-xiang;MA Jie;HE Xue-jiao(Department of Clinical Laboratory,the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)
出处
《南昌大学学报(医学版)》
2025年第1期58-63,共6页
Journal of Nanchang University:Medical Sciences
基金
新疆维吾尔自治区卫生健康青年医学科技人才专项项目(WJWY-202219)。
关键词
中性粒细胞胞外诱捕网
激活
单核细胞
急性呼吸窘迫综合征
病情
预后
neutrophil extracellular trap
activation
monocyte
acute respiratory distress syndrome
disease severity
prognosis
