利用细胞因子谱指标预测鼻窦炎患者并发症的发生

N. Baranova, L. A. Aschina, A. V. Fedin, N. Shkurova, S. V. Sergeev
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摘要

的目标。目的:建立基于细胞因子谱研究的鼻窦炎患者并发症预测方法。方法。我们检查了110例鼻窦炎患者和30例健康供体(对照组)。将患者分为无并发鼻窦炎组(第一组,n=65)和并发鼻窦炎组(第二组,n=45)。采用酶免疫分析法测定血清白细胞介素(IL)-1、IL-4、IL-8、IL-10、IL-17、IL-18、干扰素(IFN)-的水平。采用Microsoft Excel 2013和Statistica 12.0软件对结果进行统计分析。比较组间差异有统计学意义,采用MannWhitney u检验,p < 0.05。多因素分析包括相关分析和逐步回归分析。数学模型一致性采用Fisher’s f检验,p < 0.05被认为是显著的。结果。无并发症鼻窦炎患者的细胞因子谱变化表现为白细胞介素-1 (p=0.00001)、白细胞介素-4 (p=0.045)水平降低,白细胞介素-18 (p=0.00001)水平升高。鼻窦炎的复杂病程表现为白细胞介素-1 (p=0.00002)、白细胞介素-4 (p=0.049)水平降低,白细胞介素-8 (p=0.023)、白细胞介素-17 (p=0.00015)、白细胞介素-18 (p=0.0002)水平升高。对比分析第一组和第二组患者,合并鼻窦炎组患者白细胞介素-8 (p=0.00001)、白细胞介素-17 (p=0.0001)水平升高,白细胞介素-18 (p=0.00045)水平降低。基于白细胞介素-17、白细胞介素-8和白细胞介素-18的水平,建立了预测鼻窦炎患者并发症发生的数学模型。结论。鼻窦炎的复杂病程表现为白细胞介素-1、白细胞介素-4水平下降,白细胞介素-17、白细胞介素-8和白细胞介素-18水平升高,表明炎症过程更为明显;对于个性化治疗,基于白细胞介素-17、白细胞介素-8和白细胞介素-18水平的方法被开发出来,在此基础上可以预测鼻窦炎患者复杂病程的发展。
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Predicting the development of complications in patients with rhinosinusitis by cytokine profile indicators
Aim. To develop a method for predicting the development of complications in rhinosinusitis patients based on the cytokine profile study. Methods. We examined 110 patients with rhinosinusitis and 30 healthy donors (control group). The patients were divided into the group without a complicated course of rhinosinusitis (first group, n=65) and the group with a complicated course of rhinosinusitis (second group, n=45). The blood serum levels of interleukin (IL)-1, IL-4, IL-8, IL-10, IL-17, IL-18, interferon (IFN)- were determined by enzyme immunoassay. Statistical analysis of the results was performed by using Microsoft Excel 2013 and Statistica 12.0 software. Statistically significant differences between the compared groups were determined by using the MannWhitney U-test, and p 0.05 was considered significant. Multivariate analysis included correlation analysis and stepwise regression analysis. The mathematical model consistency was determined by using Fisher's F-test, and p 0.05 was considered significant. Results. Changes in cytokine profile manifested by a decrease in the level of interleukin-1 (p=0.00001), interleukin-4 (p=0.045) and an increase in the level of interleukin-18 (p=0.00001) were revealed in patients with uncomplicated course of rhinosinusitis. The complicated course of rhinosinusitis was characterized by a decrease in the level of interleukin-1 (p=0.00002), interleukin-4 (p=0.049) and an increase in the level of interleukin-8 (p=0.023), interleukin-17 (p=0.00015) and interleukin-18 (p=0.0002). Comparative analysis of the first and the second groups of patients showed an increased level of interleukin-8 (p=0.00001), interleukin-17 (p=0.0001) and reduced levels of interleukin-18 (p=0.00045) in the group of patients with complicated course of rhinosinusitis. Based on interleukin-17, interleukin-8 and interleukin-18 levels, the mathematical model for predicting the development of complications in patients with rhinosinusitis was developed. Conclusion. The complicated course of rhinosinusitis was characterized by decreased levels of interleukin-1, interleukin-4 and increased levels of interleukin-17, interleukin-8 and interleukin-18, indicating a more pronounced inflammatory process; for personalized therapy, an approach based on interleukin-17, interleukin-8 and interleukin-18 levels was developed on which the development of a complicated course in patients with rhinosinusitis can be predicted.
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