脓毒症病人外周血IL-2R、FOXP3及调节性T细胞水平与病人病情严重程度和预后的相关性分析

赵志涛; 杜蕊; 郝丽娜; 李栋梁

doi:10.13898/j.cnki.issn.2097-5252.2025.07.012

脓毒症病人外周血IL-2R、FOXP3及调节性T细胞水平与病人病情严重程度和预后的相关性分析

Correlation analysis of IL-2R, FOXP3 and regulatory T cell levels in peripheral blood of sepsis patients with the severity and prognosis of sepsis

摘要

摘要:
目的探究脓毒症病人外周血白细胞介素-2受体(IL-2R)、叉头/翼状螺旋转录因子p3(FOXP3)及调节性T(Treg)细胞水平与脓毒症病人的病情严重程度和预后的相关性。
方法选取80例脓毒症病人作为观察组，根据病人28 d预后结果分为死亡组和生存组；选取同期健康体检者75名作为对照组。采用ELISA法检测血清IL-2R水平，RT-qPCR检测FOXP3水平，流式细胞术测定外周血Treg细胞水平，Pearson法分析外周血IL-2R、FOXP3、Treg细胞水平与急性生理与慢性健康评分(APACHEⅡ)、序贯器官衰竭评分(SOFA)的相关性，Cox回归分析脓毒症预后的影响因素，ROC曲线评价外周血IL-2R、FOXP3、Treg细胞水平单独及其联合对脓毒症病人28 d预后的预测效能。
结果观察组病人外周血IL-2R、FOXP3及Treg细胞水平均明显高于对照组(P < 0.01)。死亡组病人外周血中IL-2R、FOXP3、Treg细胞水平均高于生存组(P < 0.05~P < 0.01)。与生存组相比，死亡组病人APACHEⅡ评分、SOFA评分明显增加(P < 0.01)。脓毒症病人外周血IL-2R水平与FOXP3水平、Treg细胞水平、APACHEⅡ评分、SOFA评分均呈正相关关系(r=0.611、0.583、0.579、0.558，P < 0.05)；FOXP3水平与Treg细胞水平、APACHEⅡ评分、SOFA评分均呈正相关关系(r=0.594、0.585、0.622，P < 0.05)；Treg细胞水平与APACHEⅡ评分、SOFA评分均呈正相关关系(r=0.572、0.554，P < 0.05)。COX回归分析显示，IL-2R、FOXP3、Treg细胞均是影响脓毒症病人预后的独立危险因素(P < 0.01)。ROC曲线分析显示，外周血IL-2R、FOXP3、Treg细胞水平及三者联合预测脓毒症病人不良预后结局的AUC分别为0.717、0.712、0.790、0.829，其中联合预测AUC高于三者单独预测AUC(P < 0.05)。
结论脓毒症病人外周血IL-2、Foxp3、Treg细胞水平显著升高，与病情严重程度和预后关系密切，可能用于脓毒症病人的预后评估。

Abstract:
Objective To investigate the correlation between the levels of interleukin-2 receptor (IL-2R), forkhead/winged helix spiral transcription factor p3 (FOXP3), and regulatory T (Treg) cells in peripheral blood of sepsis patients and the severity and prognosis of sepsis.
Methods Eighty sepsis patients were selected as the observation group and divided into a death group and a survival group based on their 28-day prognosis, and 75 health examinees during the same period were selected as the control group.ELISA was used to detect serum IL-2R levels; RT-qPCR was applied to determine FOXP3 levels; flow cytometry was employed to measure peripheral blood Treg cell levels; Pearson analysis was performed to analyze the correlation between peripheral blood IL-2R, FOXP3, Treg cell levels and acute physiology and chronic health score (APACHEⅡ), sequential organ failure score (SOFA); COX regression was carried out to analyze the influencing factors of sepsis prognosis; ROC curve was used to evaluate the predictive efficacy of peripheral blood IL-2R, FOXP3, Treg cell levels alone and in combination on 28-day prognosis of sepsis patients.
Results The levels of IL-2R, FOXP3, and Treg cells in the peripheral blood of patients in the observation group were significantly higher than those in the control group (P < 0.01).The levels of IL-2R, FOXP3, and Treg cells in the peripheral blood of patients in the death group were higher than those in the survival group (P < 0.05 to P < 0.01).Compared with the survival group, the APACHEⅡ score and SOFA score of patients in the death group were significantly increased (P < 0.01).The IL-2R levels in peripheral blood of sepsis patients were positively correlated with FOXP3 levels, Treg cell levels, APACHEⅡ score, and SOFA score (r=0.611, 0.583, 0.579, 0.558, P < 0.05);FOXP3 levels were positively correlated with Treg cell levels, APACHEⅡ score, and SOFA score (r=0.594, 0.585, 0.622, P < 0.05);Treg cell levels were positively correlated with APACHEⅡ score and SOFA score (r=0.572, 0.554, P < 0.05).COX regression analysis showed that IL-2R, FOXP3, and Treg cells were independent risk factors affecting the prognosis of sepsis patients (P < 0.01).ROC curve analysis indicated the AUC of IL-2R, FOXP3, Treg cell levels in peripheral blood and their combination for predicting adverse prognosis in sepsis patients were 0.717, 0.712, 0.790, and 0.829, respectively.Among them, the AUC of the combined prediction was higher than that of the individual prediction (P < 0.05).
Conclusions The levels of IL-2, Foxp3 and Treg cells in the peripheral blood of sepsis patients are greatly increased, which is closely related to the severity of disease and prognosis, and may be used to evaluate the prognosis of sepsis patients.

HTML全文

参考文献(15)

施引文献

资源附件(0)