[1]石玉英,段训新,黄 龙.老年社区获得性肺炎并脓毒症患者sCD14和CD14+/HLA-DR表达及意义[J].医学信息,2020,33(02):86-88.[doi:10.3969/j.issn.1006-1959.2020.02.023]
 SHI Yu-ying,DUAN Xun-xin,HUANG Long.Expression and Significance of sCD14 and CD14+/HLA-DR in Elderly Patients with Community Acquired Pneumonia and Sepsis[J].Medical Information,2020,33(02):86-88.[doi:10.3969/j.issn.1006-1959.2020.02.023]
点击复制

老年社区获得性肺炎并脓毒症患者sCD14和CD14+/HLA-DR表达及意义()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年02期
页码:
86-88
栏目:
论著
出版日期:
2020-01-15

文章信息/Info

Title:
Expression and Significance of sCD14 and CD14+/HLA-DR in Elderly Patients with Community Acquired Pneumonia and Sepsis
文章编号:
1006-1959(2020)02-0086-03
作者:
石玉英段训新黄 龙
(九江学院附属医院检验科,江西 九江 332000)
Author(s):
SHI Yu-yingDUAN Xun-xinHUANG Long
(Department of Laboratory Medicine,the Affiliated Hospital of Jiujiang University,Jiujiang 332000,Jiangxi,China)
关键词:
社区获得性肺炎脓毒症sCD14CD14+/HLA-DR
Keywords:
ommunityacquired pneumoniaSepsissCD14CD14+/HLA-DR
分类号:
R631
DOI:
10.3969/j.issn.1006-1959.2020.02.023
文献标志码:
A
摘要:
目的 探讨老年社区获得性肺炎(CAP)并脓毒症患者血清sCD14和外周血单核细胞CD14+/HLA-DR表达水平及临床意义。方法 选取2015年1月~2018年12月我院呼吸内科及ICU收治的老年CAP患者126例,根据是否并发脓毒症将老年CAP患者分为脓毒症组56例,非脓毒症组70例,另选择老年健康体检者45例为对照组,脓毒症组根据是否存活分为死亡组30例及存活组26例。采用ELISA法和流式细胞术检测并比较各组血清sCD14及外周血单核细胞CD14+/HLA-DR+表达水平,脓毒症组及非脓毒症组48 h CURB-65评分、28 d死亡率。结果 脓毒症组血清sCD14水平高于非脓毒症组和对照组,而CD14+/HLA-DR+表达水平则低于非脓毒症组和对照组,差异均有统计学意义(P<0.05)。死亡组血清sCD14水平高于存活组,CD14+/HLA-DR表达水平低于死亡组,差异有统计学意义(P<0.05);相关分析显示,血清sCD14水平与CURB-65评分和28 d死亡率呈正相关(r=0.750、0.712,P<0.05),而与CD14+/HLA-DR呈负相关(r=-0.692,P<0.05),CD14+/HLA-DR与CURB-65评分和28 d死亡率呈负相关(r=-0.653、-0.721,P<0.05)。结论 老年社区获得性肺炎并脓毒症患者存在免疫失衡,血清sCD14和CD14+/HLA-DR表达水平与CURB-65评分和28 d死亡率密切相关,可作为早期预测感染性疾病病情严重程度和预后的免疫学指标。
Abstract:
Objective To investigate the expression levels and clinical significance of sCD14 and peripheral blood mononuclear cells CD14+/ HLA-DR in elderly patients with community acquired pneumonia (CAP) and sepsis.Methods From January 2015 to December 2018, 126 elderly CAP patients admitted to our hospital’s Department of Respiratory Medicine and ICU were selected. According to the presence or absence of sepsis, elderly CAP patients were divided into 56 cases of sepsis and 70 cases of non-septic In addition,45 elderly healthy people were selected as the control group. ELISA and flow cytometry were used to detect and compare the serum sCD14 and CD14+/ HLA-DR+ expression levels of serum sCD14 and peripheral blood mononuclear cells in each group, 48h CURB-65 score, and 28d mortality in sepsis and non-septic groups. Sepsis group was divided into 30 cases of death group and 26 cases of survival group according to survival.Results The serum sCD14 level in the sepsis group was higher than that in the non-septic group and the control group, while the expression level of CD14+/HLA-DR+ was lower than that in the non-septic group and the control group,the differences were statistically significant(P<0.05). The serum sCD14 level in the death group was higher than that in the survival group, and the expression level of CD14+/HLA-DR was lower than that in the death group,the difference was statistically significant(P<0.05). Correlation analysis showed that serum sCD14 level was positively correlated with CURB-65 score and mortality (r=0.750,0.712,P<0.05),but negatively correlated with CD14+/HLA-DR (r=-0.692,P<0.05),CD14+/HLA-DR was negatively correlated with CURB-65 score and mortality (r=-0.653,-0.721,P<0.05).Conclusion Immunological imbalance exists in elderly patients with communityacquired pneumonia and sepsis. Serum sCD14 and CD14+/HLA-DR expression levels are closely related to CURB-65 scores and mortality, which can be used as an early predictor of the severity and prognosis of infectious diseases index.

参考文献/References:

[1]Bender MT,Niederman MS.Improving outcomes in community-acquired pneumonia[J].Current Opinion in Pulmonary Medicine,2016,22(3):235-242. [2]Ouellette DR,Moscoso EE,Corrales JP,et al.Sepsis outcomes in patients receiving statins prior to hospitalization for sepsis:comparison of in-hospital mortality rates between patients who received atorvastatin and those who received simvastatin[J].Annals of Intensive Care,2015,5(1):9-16. [3]Angus DC,van der Poll T.Severe sepsis and septic shock[J].N Engl J Med,2013,369(9):840-851. [4]Seeley EJ,Matthay MA,Wolters PJ.Inflection points in sepsis biology: from local defense to systemic organ injury[J].American Journal of Physiology-Lung Cellular and Molecular Physiology,2012,303(5):L355-L363. [5]Glück T,Silver J,Epstein M,et al.Parameters influencing membrane CD14 expression and soluble CD14 levels in sepsis[J].European Journal of Medical Research,2001,6(8):351-358. [6]Winkler MS,Rissiek A,Priefler M,et al.Human leucocyte antigen (HLA-DR) gene expression is reduced in sepsis and correlates with impaired TNFα response:A diagnostic tool for immunosuppression?[J].PLoS One,2017,12(8):e0182427. [7]中华医学会呼吸病学分会.中国成人社区获得性肺炎诊断和治疗指南(2016年版)[J].中华结核和呼吸杂志,2016,4(39):1-27. [8]Singer M,Deutschman CS,Seymour CW,et al.The Third International Consensus Definitions for Sepsis and Septic Shock(Sepsis-3)[J].The Journal of the American Medical Association,2016, 315(8):775-787. [9]赖丽仁.新型脓毒症生物标志物Presepsin(sCD14-亚型)的研究进展[J].中华重症医学电子杂志,2017, 3(3):178-181. [10]Yaegashi Y,Shirakawa K,Sato N,et al.Evaluation of a newly identified soluble CD14 subtype as a marker for sepsis[J].Journal of Infection&Chemotherapy,2005,11(5):234-238. [11]Kitchens RL,Thompson PA,Viriyakosol S,et al.Plasma CD14 decreases monocyte responses to LPS by transferring cell-bound LPS to plasma lipoproteins[J].Journal of Clinical Investigation, 2001,108(3):485-493. [12]Masson S,Caironi P,Fanizza C,et al.Erratum to:Circulating presepsin(soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock:data from the multicenter,randomized ALBIOS trial[J].Intensive Care Medicine,2014,41(1):12-20. [13]Lekkou A,Karakantza M,Mouzaki A,et al.Cytokine production and monocyte HLA-DR expression as predictors of outcome for patients with community-acquired severe infections[J].Clin Diagn Lab Immunol,2004,11(1):161-167. [14]苏磊,周殿元,唐柚青,等.CD14+单核细胞人白细胞DR抗原在脓毒症早期检测中的临床意义[J].中华危重病急救医学,2006,18(11):677-679.

相似文献/References:

[1]赵建美,邵 岩.血必净治疗社区获得性肺炎的研究进展[J].医学信息,2018,31(02):20.[doi:10.3969/j.issn.1006-1959.2018.02.009]
 ZHAO Jian-mei,SHAO Yan.Research Progress of Xuebijing in Treating Community Acquired Pneumonia[J].Medical Information,2018,31(02):20.[doi:10.3969/j.issn.1006-1959.2018.02.009]
[2]包克珍,许云丽.新生儿社区获得性肺炎的临床特征分析[J].医学信息,2018,31(02):184.[doi:10.3969/j.issn.1006-1959.2018.02.072]
 BAO Ke-zhen,XU Yun-li.Clinical Characteristics of Neonatal Community Acquired Pneumonia[J].Medical Information,2018,31(02):184.[doi:10.3969/j.issn.1006-1959.2018.02.072]
[3]赵建美,邵 岩,李京津.电脑中频药透对治疗老年社区获得性肺炎的疗效分析[J].医学信息,2018,31(03):146.[doi:10.3969/j.issn.1006-1959.2018.03.052]
 ZHAO Jian-mei,SHAO Yan,LI Jing-jin.Analysis of the Efficacy of Computer Medium Frequency Drug Penetration in the Treatment of Elderly Community-acquired Pneumonia[J].Medical Information,2018,31(02):146.[doi:10.3969/j.issn.1006-1959.2018.03.052]
[4]曹立杰,杨林瀛,于国云,等.N-末端脑钠肽前体与社区获得性肺炎患者严重程度关系研究[J].医学信息,2018,31(04):1.[doi:10.3969/j.issn.1006-1959.2018.04.001]
 CAO Li-jie,YANG Lin-ying,YU Guo-yun,et al.Study on the Relationship between N-terminal Brain Natriuretic Peptide Precursors and the Severity of Community-acquired Pneumonia[J].Medical Information,2018,31(02):1.[doi:10.3969/j.issn.1006-1959.2018.04.001]
[5]俞 静,赵 红,金 晶,等.社区获得性肺炎胸部CT中反晕征的初步研究[J].医学信息,2022,35(10):109.[doi:10.3969/j.issn.1006-1959.2022.10.026]
 YU Jing,ZHAO Hong,JIN Jing,et al.Preliminary Study of Reversed Halo Sign in Chest CT of Community-acquired Pneumonia[J].Medical Information,2022,35(02):109.[doi:10.3969/j.issn.1006-1959.2022.10.026]
[6]温占兵.血管生成素-1水平变化预测脓毒症急性肺损伤的价值[J].医学信息,2018,31(13):95.[doi:10.3969/j.issn.1006-1959.2018.13.027]
 WEN Zhan-bing.The Value of Angiopoietin-1 Level Change in Predicting Acute Lung Injury in Sepsis[J].Medical Information,2018,31(02):95.[doi:10.3969/j.issn.1006-1959.2018.13.027]
[7]武珊珊.喜炎平注射液治疗社区获得性肺炎临床疗效的Meta分析[J].医学信息,2018,31(14):64.[doi:10.3969/j.issn.1006-1959.2018.14.020]
 WU Shan-shan.Meta-analysis of Clinical Efficacy of Xiyanping Injection in the Treatment of Community-acquired Pneumonia[J].Medical Information,2018,31(02):64.[doi:10.3969/j.issn.1006-1959.2018.14.020]
[8]徐安林,刘 忠.不同配比的哌拉西林-他唑巴坦治疗 老年性社区获得性肺炎的疗效对比[J].医学信息,2018,31(15):129.[doi:10.3969/j.issn.1006-1959.2018.15.041]
 XU An-lin,LIU Zhong.Comparison of the Efficacy of Different Ratios of Piperacillin-tazobactam in Elderly Community Acquired Pneumoni[J].Medical Information,2018,31(02):129.[doi:10.3969/j.issn.1006-1959.2018.15.041]
[9]许 俊.慢性阻塞性肺疾病急性加重期与慢性阻塞性肺疾病并发社区获得性肺炎患者的临床对比[J].医学信息,2018,31(22):118.[doi:10.3969/j.issn.1006-1959.2018.22.033]
 XU Jun.Clinical Comparison of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Chronic Obstructive Pulmonary Disease Complicated with Community Acquired Pneumonia[J].Medical Information,2018,31(02):118.[doi:10.3969/j.issn.1006-1959.2018.22.033]
[10]远 颖.成人社区获得性肺炎中医药研究[J].医学信息,2018,31(23):55.[doi:10.3969/j.issn.1006-1959.2018.23.016]
 YUAN Ying.Traditional Chinese Medicine Research on Adult Community Acquired Pneumonia[J].Medical Information,2018,31(02):55.[doi:10.3969/j.issn.1006-1959.2018.23.016]

更新日期/Last Update: 2020-01-15