摘要
目的 探究血清免疫球蛋白和炎症因子白细胞介素-17(IL-17)、C-X-C配体10 (CXCL10)在类风湿关节炎(RA)合并感染患者鉴别诊断中的临床价值。方法 选取于2019年1月-2021年1月在滕州市中心人民医院风湿免疫科进行诊治的类风湿关节炎患者进行回顾性分析,本研究共纳入合并感染者66例(感染组),未合并感染者56例(RA组),健康体检者49例(对照组)。分析三组免疫指标及IL-17和CXCL10的差异,并对比感染组和RA组患者血清中IL-17和CXCL10水平的变化。利用受试者工作特征曲线(ROC)的曲线下面积(AUC)分析免疫球蛋白、IL-17和CXCL10指标对类风湿关节炎合并感染的诊断效能各指标对类风湿关节炎合并感染的诊断效能。结果 感染组白细胞、中性粒细胞、CRP、IL-17和CXCL10水平高于对照组与RA组(P<0.05),RA组患者CRP、IL-17和CXCL10水平高于对照组;感染组血清免疫球蛋白水平高于对照组与RA组(P<0.05)。利用ROC曲线分别对各个检测指标的预测效能进行分析,可见在联合检测组合中对类风湿关节炎合并感染的诊断效能最优(AUC=0.961)。结论 炎症因子IL-17、趋化因子CXCL10及免疫球蛋白在类风湿关节炎合并感染患者中升高,在临床鉴别诊断中可提高诊断效能。
OBJECTIVE To explore the clinical value of serum immunoglobulin and inflammatory factors interleukin 17(IL-17) and C-X-C ligand 10(CXCL10) in the differential diagnosis of patients with rheumatoid arthritis(RA) co-infection. METHODS A retrospective analysis of patients with rheumatoid arthritis who were diagnosed and treated in the Department of Rheumatology and Immunology of Tengzhou Central People′s Hospital from Jan 2019 to Jan 2021 was performed. A total of 66 cases of co-infected patients in the infected group, 56 cases of infected patients in the RA group and 49 cases of healthy volunteers in the control group were included in this study. The differences in the levels of immunology biomarkers and serum IL-17, CXCL10 levels among the three groups of patients were retrospectively analyzed, and the differences in serum IL-17 and CXCL10 levels between the infected group and RA group were analyzed. The AUC of receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficacy of immunoglobulin, IL-17 and CXCL10 indicators for rheumatoid arthritis complicated infection. RESULTS The serum levels of leukocyte, neutrophil, CRP, IL-17 and CXCL10 in infection group were significantly higher than those in the control and RA groups(P<0.001). CRP, IL-17 and CXCL10 levels in the RA group were significantly higher than those in the control group. The level of serum immunoglobulin in infection group was significantly higher than that in control group and RA group(P<0.05). The ROC curve was used to analyze the predictive performance of the indexes including immunoglobulin, IL-17 and CXCL10. It showed that the combined detection had the best diagnostic performance for rheumatoid arthritis co-infection(AUC= 0.961). CONCLUSION Inflammatory factors IL-17, chemokine CXCL10 and immunoglobulin increase significantly in patients with rheumatoid arthritis co-infection. The indexes can improve the efficacy in clinical differential diagnosis.
作者
白景芝
王利
王坤坤
甘艳
BAI Jing-zhi;WANG Li;WANG Kun-kun;GAN Yan(Teng Zhou Central People's Hospital,Tengzhou,Shandong 277599,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第16期2479-2482,共4页
Chinese Journal of Nosocomiology
基金
山东省自然科学基金资助项目(ZR2015CM025)。
