劳力性中暑患者血清白细胞介素-6、血清淀粉样蛋白A和C-反应蛋白水平变化及相关性分析
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摘要
目的探讨白细胞介素6(interleukin-6,IL-6)、血清淀粉样蛋白A(serumamyloid A,SAA)和C-反应蛋白(CRP)在劳力性中暑患者中的变化规律及相关性。方法应用ELISA方法检测24例劳力性中暑患者和24例健康对照血清IL-6、SAA和CRP浓度;统计学处理采用非参数检验分析组间差异,动态变化采用重复t检验,Pearson方法分析劳力性中暑患者IL-6、SAA和CRP之间的相关性。结果与对照组相比,劳力性中暑患者血清IL-6、SAA和CRP浓度显著升高(P<0.01),并且IL-6、SAA和CRP水平呈正相关(P<0.01);劳力性中暑患者IL-6、SAA和CRP浓度发病初期不断呈上升趋势,第5 d达到高峰后开始下降。结论劳力性中暑患者血清IL-6、SAA和CRP水平显著升高,彼此呈正相关,并且在短期内呈逐步上升趋势,对于患者发病早期的判断意义重大。
Objective To investigate the regularity and correlation of IL-6, SAA, and CRP in patients with exertional heatstroke. Methods Serum IL-6, SAA, and CRP levels were measured in 24 patients with exertional heatstroke and 24 controls by enzyme-linked immuno sorbent assay(ELISA). Non-parametric tests were used to analyze the differences between groups. Repeated t-tests were used for dynamic changes. Pearson's method was used to analyze the relationship among IL-6, SAA, and CRP in patients with exertional heatstroke. Results Serum IL-6, SAA, and CRP levels were significantly higher in patients with exertional heatstroke compared with healthy controls(P<0.01), and IL-6 and SAA levels were positively correlated with CRP level(P<0.01). The concentrations of IL-6, SAA, and CRP in patients showed an upward trend at the beginning of the disease and began to decline after peaking on the fifth day. Conclusion The levels of serum IL-6, SAA, and CRP in workers with exertional heatstroke were significantly higher and correlated with each other, which showed a gradual increase in short-term and was significant for the early diagnosis of patients.
Objective To investigate the regularity and correlation of IL-6, SAA, and CRP in patients with exertional heatstroke. Methods Serum IL-6, SAA, and CRP levels were measured in 24 patients with exertional heatstroke and 24 controls by enzyme-linked immuno sorbent assay(ELISA). Non-parametric tests were used to analyze the differences between groups. Repeated t-tests were used for dynamic changes. Pearson's method was used to analyze the relationship among IL-6, SAA, and CRP in patients with exertional heatstroke. Results Serum IL-6, SAA, and CRP levels were significantly higher in patients with exertional heatstroke compared with healthy controls(P<0.01), and IL-6 and SAA levels were positively correlated with CRP level(P<0.01). The concentrations of IL-6, SAA, and CRP in patients showed an upward trend at the beginning of the disease and began to decline after peaking on the fifth day. Conclusion The levels of serum IL-6, SAA, and CRP in workers with exertional heatstroke were significantly higher and correlated with each other, which showed a gradual increase in short-term and was significant for the early diagnosis of patients.
引文
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[10] 龚菲,刘世国,孔莹,等.SAA和CRP联合检测在小儿感染性疾病鉴别诊断中的应用价值[J].中国微生态学杂志,2015,27(4):429-430.
[11] Uhde M,Ajamian M,Li X,et al.Expression of C-reactive protein and serum amyloid A in early to late manifestations of lyme disease[J].Clin Infect Dis,2016,63(11):1399-1404.
[12] Vollmer AH,Gebre MS,Barnard DL.Serum amyloid A (SAA) is an early biomarker of influenza virus disease in BALB/c,C57BL/2,Swiss-Webster,and DBA.2 mice[J].Antiviral Res,2016,133:196-207.
[13] Dahan E,Dichtwald S,Amar E,et al.Low plasma C-reactive protein level as an early diagnostic tool for heatstroke vs central nervous system-associated infection in the ED[J].Am J Emerg Med,2013,31(8):1176-1180.
[14] Gil HY,Balasubramani GK,Metes ID,et al.Differential response of serum amyloid A to different therapies in early rheumatoid arthritis and its potential value as a disease activity biomarker[J].Arthritis Res Ther,2016,18(1):108.
[15] Cetinkaya M,Ozkan H,K?ksal N,et al.Comparison of the efficacy of serum amyloid A,C-reactive protein,and procalcitonin in the diagnosis and follow-up of necrotizing enterocolitis in premature infants[J].J Pediatr Surg,2011,46(8):1482-1489.
[2] Tanaka T,Narazaki M,Kishimoto T.IL-6 in inflammation,immunity,and disease[J].Cold Spring Harb Perspect Biol,2014,6(10):a016295.
[3] Malle E,De Beer FC.Human serum amyloid A (SAA) protein:a prominent acute-phase reactant for clinical practice[J].Eur J Clin Invest,1996,26(6):427-435.
[4] 丁红辉,王成刚.血清淀粉样蛋白A与C-反应蛋白比值在鉴别诊断儿童病毒与细菌感染性疾病中的价值[J].中国卫生检验杂志,2016,26(21):3165-3166.
[5] Lu KC,Wang JY,Lin SH,et al.Role of circulating cytokines and chemokines in exertional heatstroke[J].Crit Care Med,2004,32(2):399-403.
[6] Heled Y,Fleischmann C,Epstein Y.Cytokines and their role in hyperthermia and heat stroke[J].J Basic Clin Physiol Pharmacol,2013,24(2):85-96.
[7] Yoshizaki K.Pathogenic role of IL-6 combined with TNF-alpha or IL-1 in the induction of acute phase proteins SAA and CRP in chronic inflammatory diseases[J].Adv Exp Med Biol,2011,691:141-150.
[8] Lu J,Marjon KD,Marnell LL,et al.Recognition and functional activation of the human IgA receptor (FcalphaRI) by C-reactive protein[J].Proc Natl Acad Sci USA,2011,108(12):4974-4979.
[9] 刘燕丽,刘勋,蒋瑾瑾.人类血清淀粉样蛋白A在儿科感染性疾病诊治中的应用[J].中国卫生检验杂志,2017,27(18):2734-2736.
[10] 龚菲,刘世国,孔莹,等.SAA和CRP联合检测在小儿感染性疾病鉴别诊断中的应用价值[J].中国微生态学杂志,2015,27(4):429-430.
[11] Uhde M,Ajamian M,Li X,et al.Expression of C-reactive protein and serum amyloid A in early to late manifestations of lyme disease[J].Clin Infect Dis,2016,63(11):1399-1404.
[12] Vollmer AH,Gebre MS,Barnard DL.Serum amyloid A (SAA) is an early biomarker of influenza virus disease in BALB/c,C57BL/2,Swiss-Webster,and DBA.2 mice[J].Antiviral Res,2016,133:196-207.
[13] Dahan E,Dichtwald S,Amar E,et al.Low plasma C-reactive protein level as an early diagnostic tool for heatstroke vs central nervous system-associated infection in the ED[J].Am J Emerg Med,2013,31(8):1176-1180.
[14] Gil HY,Balasubramani GK,Metes ID,et al.Differential response of serum amyloid A to different therapies in early rheumatoid arthritis and its potential value as a disease activity biomarker[J].Arthritis Res Ther,2016,18(1):108.
[15] Cetinkaya M,Ozkan H,K?ksal N,et al.Comparison of the efficacy of serum amyloid A,C-reactive protein,and procalcitonin in the diagnosis and follow-up of necrotizing enterocolitis in premature infants[J].J Pediatr Surg,2011,46(8):1482-1489.