慢性骨髓炎患者血清IL-6、CCL11的表达水平及意义
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摘要
目的研究慢性骨髓炎(COM)患者血清白介素-6(IL-6)、CC修饰趋化因子11(CCL11)表达水平及对COM的辅助诊断价值。方法 55例COM患者为病例组,同期体检健康者50例作为对照组,分别检测2组血清IL-6和CCL11水平,分析病例组血清IL-6和CCL11之间相关性及不同病情、不同预后患者之间血清IL-6和CCL11水平差异,分析血清IL-6和CCL11水平对COM的诊断价值。结果病例组血清IL-6、CCL11水平显著高于对照组(P<0.05);病例组血清IL-6和CCL11呈正相关(r=0.774,P=0.005);重度组患者血清IL-6、CCL11水平显著高于轻度组和中度组(P<0.05),中度组患者血清IL-6、CCL11水平高于轻度组,但2组比较差异无统计学意义(P>0.05);预后不良组血清IL-6、CCL11水平显著高于预后良好组(P<0.05);血清IL-6、CCL11诊断COM的ROC曲线下面积(AUC)分别为0.815、0.831,敏感性分别为90.91%、72.73%,特异性分别为62.00%、94.00%。结论 IL-6和CCL11水平在COM患者血清中明显升高,术前检测血清IL-6和CCL11水平可作为辅助诊断COM的敏感生物学指标。
Objective To investigate the expression levels of serum interleukin-6(IL-6) and CC modified chemokine 11(CCL11) in patients with chronic osteomyelitis(COM) and their auxiliary diagnostic value for COM.Methods A total of 55 patients with COM were enrolled as case group, and 50 healthy subjects who underwent physical examination at the same period were served as control group. The serum IL-6 and CCL11 levels were detected in both groups. The correlation between serum IL-6 and CCL11 in the case group was analyzed. Moreover,the differences in the levels of serum IL-6 and CCL11 in patients with different diseases conditions and different prognosis were analyzed. The diagnostic value of serum IL-6 and CCL11 levels in COM was analyzed.Results The levels of serum IL-6 and CCL11 in case group were significantly higher than those in control group(P<0.05). There was a positive correlation between serum IL-6 and CCL11 in case group(r=0.774,P<0.01). The levels of IL-6 and CCL11 in severe COM group were significantly higher than those in mild and moderate COM groups(P<0.05). The levels of serum IL-6 and CCL11 in moderate COM group were higher than those in mild COM group, but the differences between the two groups were not statistically significant(P>0.05). The serum levels of IL-6 and CCL11 in poor prognosis group were significantly higher than those in good prognosis group(P<0.05). The area under the ROC curve(AUC) of serum IL-6 and CCL11 for the diagnosis of COM was 0.815 and 0.831, respectively, and the sensitivity and specificity were 90.91% vs 72.73%, and 62.00% vs 94.00%, respectively.Conclusion The serum levels of IL-6 and CCL11 are significantly increased in patients with COM. The preoperative detection of serum levels of IL-6 and CCL11 can be used as a sensitive biological indicator for the diagnosis of COM.
Objective To investigate the expression levels of serum interleukin-6(IL-6) and CC modified chemokine 11(CCL11) in patients with chronic osteomyelitis(COM) and their auxiliary diagnostic value for COM.Methods A total of 55 patients with COM were enrolled as case group, and 50 healthy subjects who underwent physical examination at the same period were served as control group. The serum IL-6 and CCL11 levels were detected in both groups. The correlation between serum IL-6 and CCL11 in the case group was analyzed. Moreover,the differences in the levels of serum IL-6 and CCL11 in patients with different diseases conditions and different prognosis were analyzed. The diagnostic value of serum IL-6 and CCL11 levels in COM was analyzed.Results The levels of serum IL-6 and CCL11 in case group were significantly higher than those in control group(P<0.05). There was a positive correlation between serum IL-6 and CCL11 in case group(r=0.774,P<0.01). The levels of IL-6 and CCL11 in severe COM group were significantly higher than those in mild and moderate COM groups(P<0.05). The levels of serum IL-6 and CCL11 in moderate COM group were higher than those in mild COM group, but the differences between the two groups were not statistically significant(P>0.05). The serum levels of IL-6 and CCL11 in poor prognosis group were significantly higher than those in good prognosis group(P<0.05). The area under the ROC curve(AUC) of serum IL-6 and CCL11 for the diagnosis of COM was 0.815 and 0.831, respectively, and the sensitivity and specificity were 90.91% vs 72.73%, and 62.00% vs 94.00%, respectively.Conclusion The serum levels of IL-6 and CCL11 are significantly increased in patients with COM. The preoperative detection of serum levels of IL-6 and CCL11 can be used as a sensitive biological indicator for the diagnosis of COM.
引文
1 Cox AJ,Zhao Y,Ferguson PJ.Chronic recurrent multifocal osteomyelitis and related diseases-update on pathogenesis.Current Rheumatology Reports,2017,19:18.
2 边俊.79例股骨下端创伤合并慢性骨髓炎患者的外科治疗.中华全科医学,2016,14:1783-1785.
3 彭冰,宋才渊,金红婷,等.慢性骨髓炎的临床诊断与治疗.中国骨伤,2015,28:870-873.
4 Millard C,Ludeman J,Canals M,et al.Structural basis of receptor sulfotyrosine recognition by a CC chemokine:the N-terminal region of CCR3 bound to CCL11/Eotaxin-1.Structure,2014,22:1571-1581.
5 孔庆柱,杨佳宁,郭立涛,等.负压吸引持续灌注引流与抗生素骨水泥珠链治疗慢性骨髓炎临床疗效比较.河北医学,2016,22:771-774.
6 Panteli M,Puttaswamaiah R,Lowenberg DW,et al.Malignant transformation in chronic osteomyelitis:recognition and principles of management.J Am Acad Orthop Surg,2014,22:586-594.
7 曲小雨,范小斌,牛志莹,等.骨感染患者血清炎性因子水平分析.中华医院感染学杂志,2016,26:3500-3502.
8 陆骁臻,袁义,胡耀仁,等.开放性骨折感染患者血清炎性因子的变化分析.中华医院感染学杂志,2018,28:879-882.
9 Ettinger M,Calliess T,Kielstein JT,et al.Circulating biomarkers for discrimination between aseptic joint failure,low-grade infection,and high-grade septic failure.Clinical Infectious Diseases,2015,61:332.
10 Hoell S,Borgers L,Gosheger G,et al.Interleukin-6 in two-stage revision arthroplasty:what is the threshold value to exclude persistent infection before re-implanatation.Bone Joint J,2015,97:71-75.
11 Jiang N,Qin CH,Hou YL,et al.Serum TNF-α,erythrocyte sedimentation rate and IL-6 are more valuable biomarkers for assisted diagnosis of extremity chronic osteomyelitis.Biomarkers in Medicine,2017,11:597-605.
12 Ridiandries A,Bursill C,Tan J.Broad-spectrum inhibition of the CC-chemokine class improves wound healing and wound angiogenesis.Int J Mol Sci,2017,18:155-162.
13 Waddell A,Ahrens R,Steinbrecher KA,et al.Mo1792 intestinal CCL11 and eosinophilic inflammation is regulated by myeloid cell-specific relA/p65 in mice.Gastroenterology,2012,142:S686-S691.
14 Kindstedt E,Holm CK,Sulniute R,et al.CCL11,a novel mediator of inflammatory bone resorption.Scientific Reports,2017,7:5334-5344.
15 Qi H,Duan L,Xin Q,et al.IL-17 Promotes Angiogenic Factors IL-6,IL-8,and Vegf Production via Stat1 in Lung Adenocarcinoma.Sci Rep,2016,6:36551.
16 马蕾,薛海波,管秀好,等.IL-17对角质形成细胞表达CC型趋化因子的影响.中国皮肤性病学杂志,2013,27:982-985.
17 Hofmann SR,B?ttger F,Range U,et al.Serum interleukin-6 and CCL11/Eotaxin may be suitable biomarkers for the diagnosis of chronic nonbacterial osteomyelitis.Frontiers in Pediatrics,2017,5:256.
2 边俊.79例股骨下端创伤合并慢性骨髓炎患者的外科治疗.中华全科医学,2016,14:1783-1785.
3 彭冰,宋才渊,金红婷,等.慢性骨髓炎的临床诊断与治疗.中国骨伤,2015,28:870-873.
4 Millard C,Ludeman J,Canals M,et al.Structural basis of receptor sulfotyrosine recognition by a CC chemokine:the N-terminal region of CCR3 bound to CCL11/Eotaxin-1.Structure,2014,22:1571-1581.
5 孔庆柱,杨佳宁,郭立涛,等.负压吸引持续灌注引流与抗生素骨水泥珠链治疗慢性骨髓炎临床疗效比较.河北医学,2016,22:771-774.
6 Panteli M,Puttaswamaiah R,Lowenberg DW,et al.Malignant transformation in chronic osteomyelitis:recognition and principles of management.J Am Acad Orthop Surg,2014,22:586-594.
7 曲小雨,范小斌,牛志莹,等.骨感染患者血清炎性因子水平分析.中华医院感染学杂志,2016,26:3500-3502.
8 陆骁臻,袁义,胡耀仁,等.开放性骨折感染患者血清炎性因子的变化分析.中华医院感染学杂志,2018,28:879-882.
9 Ettinger M,Calliess T,Kielstein JT,et al.Circulating biomarkers for discrimination between aseptic joint failure,low-grade infection,and high-grade septic failure.Clinical Infectious Diseases,2015,61:332.
10 Hoell S,Borgers L,Gosheger G,et al.Interleukin-6 in two-stage revision arthroplasty:what is the threshold value to exclude persistent infection before re-implanatation.Bone Joint J,2015,97:71-75.
11 Jiang N,Qin CH,Hou YL,et al.Serum TNF-α,erythrocyte sedimentation rate and IL-6 are more valuable biomarkers for assisted diagnosis of extremity chronic osteomyelitis.Biomarkers in Medicine,2017,11:597-605.
12 Ridiandries A,Bursill C,Tan J.Broad-spectrum inhibition of the CC-chemokine class improves wound healing and wound angiogenesis.Int J Mol Sci,2017,18:155-162.
13 Waddell A,Ahrens R,Steinbrecher KA,et al.Mo1792 intestinal CCL11 and eosinophilic inflammation is regulated by myeloid cell-specific relA/p65 in mice.Gastroenterology,2012,142:S686-S691.
14 Kindstedt E,Holm CK,Sulniute R,et al.CCL11,a novel mediator of inflammatory bone resorption.Scientific Reports,2017,7:5334-5344.
15 Qi H,Duan L,Xin Q,et al.IL-17 Promotes Angiogenic Factors IL-6,IL-8,and Vegf Production via Stat1 in Lung Adenocarcinoma.Sci Rep,2016,6:36551.
16 马蕾,薛海波,管秀好,等.IL-17对角质形成细胞表达CC型趋化因子的影响.中国皮肤性病学杂志,2013,27:982-985.
17 Hofmann SR,B?ttger F,Range U,et al.Serum interleukin-6 and CCL11/Eotaxin may be suitable biomarkers for the diagnosis of chronic nonbacterial osteomyelitis.Frontiers in Pediatrics,2017,5:256.