血清IL-2、IL-6、IL-8和IL-10对肠易激综合征患者预后不良的预测价值

doi:10.3969/j.issn.1673-8640.2024.09.010

摘要/Abstract

摘要：

目的探讨血清白细胞介素（IL）-2、IL-6、IL-8和IL-10水平在肠易激综合征（IBS）患者预后评估中的价值。方法选取2020年2月—2022年12月青海省中医院IBS患者102例，对所有患者随访3个月，根据预后情况分为预后不良组和预后良好组。收集所有患者的一般资料，并检测治疗前的血常规[白细胞（WBC）计数、淋巴细胞绝对数（LYMPH#）、中性粒细胞绝对数（NEUT#）]和血清C反应蛋白（CRP）、降钙素原（PCT）、IL-2、IL-6、IL-8、IL-10水平。采用Spearman相关分析评估各项指标与IBS患者预后不良的相关性。采用Logistic回归分析评估IBS患者预后不良的危险因素。采用受试者工作特征（ROC）曲线评价血清IL-2、IL-6、IL-8和IL-10判断IBS患者预后不良的效能。结果 102例IBS患者中预后不良28例，预后良好74例。预后不良组治疗前血清IL-2、IL-6和IL-8水平均显著高于预后良好组（P<0.01），血清IL-10水平显著低于预后良好组（P<0.001）。2个组之间WBC计数、LYMPH#、NEUT#、CRP、PCT水平差异均无统计学意义（P>0.05）。IL-2、IL-6、IL-8与IBS患者预后不良均呈正相关（r值分别为0.445、0.445、0.343，P<0.01），与IL-10呈负相关（r=-0.402，P<0.01）。IL-2、IL-6、IL-8升高和IL-10降低均是IBS患者预后不良的独立危险因素[比值比（OR）值分别为1.803、1.379、1.133、0.769，95%可信区间（CI）分别为1.307~2.488、1.152~1.651、1.001~1.282、0.651~0.908，P<0.05]。血清IL-2、IL-6、IL-8和IL-10单项检测和联合检测判断IBS患者预后不良的ROC曲线下面积（AUC）分别为0.788、0.788、0.722、0.760、0.945。结论血清IL-2、IL-6、IL-8和IL-10联合检测有助于IBS患者预后不良的评估。

关键词: 白细胞介素-2, 白细胞介素-6, 白细胞介素-8, 白细胞介素-10, 肠易激综合征

Abstract:

Objective To investigate the roles of serum interleukin（IL）-2，IL-6，IL-8 and IL-10 in the evaluation of poor prognosis in patients with irritable bowel syndrome （IBS）. Methods A total of 102 patients with IBS were enrolled from Qinghai Provincial Hospital of Traditional Chinese Medicine from February 2020 to December 2022. All the patients were followed up for 3 months and classified into poor prognosis group and good prognosis group. The general data of all the patients were collected，and blood routine test items [white blood cell（WBC） count，the absolute value of lymphocytes （LYMPH#） and the absolute value of neutrophils （NEUT#） ] and serum C-reactive protein （CRP），procalcitonin （PCT），IL-2，IL-6，IL-8 and IL-10 were determined before treatment. Spearman correlation analysis was used to evaluate the correlation between various indicators and poor prognosis in patients with IBS. Logistic regression analysis was used to evaluate the risk factors for poor prognosis in patients with IBS. The efficacy of serum IL-2，IL-6，IL-8 and IL-10 in determining poor prognosis in patients with IBS was evaluated by receiver operating characteristic （ROC） curve. Results Among the 102 patients with IBS，28 cases had poor prognosis，and 74 cases had good prognosis. Before treatment，serum IL-2，IL-6 and IL-8 levels in poor prognosis group were higher than those in good prognosis group （P<0.01），and serum IL-10 levels were lower than those in good prognosis group （P<0.001）. There was no statistical significance among WBC count，LYMPH#，NEUT#，CRP and PCT levels between the 2 groups （P>0.05）. IL-2，IL-6 and IL-8 were positively correlated with poor prognosis in IBS patients （r=0.445，0.445 and 0.343，P<0.01），and they were negatively correlated with IL-10 （r=-0.402，P<0.01）. The increase of IL-2，IL-6 and IL-8 and the decrease of IL-10 were all independent risk factors for poor prognosis in IBS patients [odds ratios （OR） were 1.803，1.379，1.133 and 0.769，95% confidence intervals （CI） were 1.307-2.488，1.152-1.651，1.001-1.282 and 0.651-0.908，respectively，P<0.05]. The areas under curves （AUC） of serum IL-2，IL-6，IL-8 and IL-10 were 0.788，0.788，0.722，0.760 and 0.945 for the poor prognosis of patients with IBS. Conclusions he combined determination of serum IL-2，IL-6，IL-8 and IL-10 is helpful to evaluate the poor prognosis of patients with IBS.

Key words: Interleukin-2, Interleukin-6, Interleukin-8, Interleukin-10, Irritable bowel syndrome

中图分类号:

R446.1

权荣荣, 王敏. 血清IL-2、IL-6、IL-8和IL-10对肠易激综合征患者预后不良的预测价值[J]. 检验医学, 2024, 39(9): 875-879.

QUAN Rongrong, WANG Min. Prognostic value of serum IL-2，IL-6，IL-8 and IL-10 in patients with irritable bowel syndrome[J]. Laboratory Medicine, 2024, 39(9): 875-879.

图/表 5

参考文献 24

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组别	例数	性别		年龄/岁	IBS病程/年	BMI/ （kg·m-2）	基础疾病			吸烟史/例	饮酒史/例
组别	例数	男/例	女/例	年龄/岁	IBS病程/年	BMI/ （kg·m-2）	高血压/例	2型糖尿病/例	冠心病/例	吸烟史/例	饮酒史/例
预后不良组	28	16	12	39.39±7.39	4.07±1.59	23.07±1.95	6	7	4	19	14
预后良好组	74	43	31	37.82±6.49	4.41±1.59	23.15±2.41	15	14	11	46	33
统计值		0.008		1.049	0.949	0.158	0.017	0.459	0.005	0.285	0.239
P值		0.930		0.297	0.345	0.875	0.897	0.498	0.941	0.593	0.625

组别	例数	性别		年龄/岁	IBS病程/年	BMI/ （kg·m-2）	基础疾病			吸烟史/例	饮酒史/例
组别	例数	男/例	女/例	年龄/岁	IBS病程/年	BMI/ （kg·m-2）	高血压/例	2型糖尿病/例	冠心病/例	吸烟史/例	饮酒史/例
预后不良组	28	16	12	39.39±7.39	4.07±1.59	23.07±1.95	6	7	4	19	14
预后良好组	74	43	31	37.82±6.49	4.41±1.59	23.15±2.41	15	14	11	46	33
统计值		0.008		1.049	0.949	0.158	0.017	0.459	0.005	0.285	0.239
P值		0.930		0.297	0.345	0.875	0.897	0.498	0.941	0.593	0.625

组别	例数	WBC计数/（×109·L-1）	LYMPH#/（×109·L-1）	NEUT#/（×109·L-1）	CRP/（mg·L-1）
预后不良组	28	6.41±1.87	1.86±0.52	2.28±0.89	9.72±3.05
预后良好组	74	6.18±2.16	1.91±0.55	2.35±0.88	9.95±2.65
t值		0.490	0.427	0.344	0.378
P值		0.625	0.670	0.732	0.707
组别	PCT/（ng·L-1）	IL-2/（pg·mL-1）	IL-6/（pg·mL-1）	IL-8/（pg·mL-1）	IL-10/（pg·mL-1）
预后不良组	0.38±0.14	10.56±3.08	18.23±5.08	24.89±5.70	8.58±3.65
预后良好组	0.37±0.11	7.12±2.77	13.35±3.67	20.12±6.66	12.68±4.62
t值	0.247	5.422	5.363	3.348	4.224
P值	0.805	<0.001	<0.001	0.001	<0.001

组别	例数	WBC计数/（×109·L-1）	LYMPH#/（×109·L-1）	NEUT#/（×109·L-1）	CRP/（mg·L-1）
预后不良组	28	6.41±1.87	1.86±0.52	2.28±0.89	9.72±3.05
预后良好组	74	6.18±2.16	1.91±0.55	2.35±0.88	9.95±2.65
t值		0.490	0.427	0.344	0.378
P值		0.625	0.670	0.732	0.707
组别	PCT/（ng·L-1）	IL-2/（pg·mL-1）	IL-6/（pg·mL-1）	IL-8/（pg·mL-1）	IL-10/（pg·mL-1）
预后不良组	0.38±0.14	10.56±3.08	18.23±5.08	24.89±5.70	8.58±3.65
预后良好组	0.37±0.11	7.12±2.77	13.35±3.67	20.12±6.66	12.68±4.62
t值	0.247	5.422	5.363	3.348	4.224
P值	0.805	<0.001	<0.001	0.001	<0.001

项目	β值	标准误	Wald值	P值	OR值（95%CI）
IL-2	0.590	0.164	12.888	<0.001	1.803（1.307~2.488）
IL-6	0.321	0.092	12.223	<0.001	1.379（1.152~1.651）
IL-8	0.125	0.063	3.890	0.049	1.133（1.001~1.282）
IL-10	-0.263	0.085	9.604	0.002	0.769（0.651~0.908）