Abstract：Objective: To study the changes of serum CXCL chemokine ligand-10 (CXCL-10) and interleukin-27 (IL-27) levels in diarrhea patients with Clostridium difficile infection (CDI) and their correlation with the severity of the disease. Metods: A total of 150 patients with diarrhea were divided into observation group (positive Cd culture,n=90) and control group (negative Cd culture,n=60) according to the results of Cd culture. The patients in observation group were further divided into mild subgroup (score<4,n=38) and moderate-severe subgroup (score≥4,n=52) according to the severity score (SSI) of CDI. The serum levels of CXCL-10 and IL-27 were detected in all the three groups, and the correlation between the serum levels of CXCL-10 and IL-27 and the severity of CDI diarrhea was analyzed. Results: The serum levels of CXCL-10 and IL-27 in the three groups were as follows: observation group>control group>healthy group (P<0.05);the serum levels of CXCL-10 and IL-27 in the moderate-severe subgroup were significantly higher than those in the mild subgroup (P<0.05).The SSI score of the observation group was (4.68±1.73), the SSI score of the mild subgroup was (3.02±0.89), and the SSI score of the moderate-severe subgroup was (5.13±1.09). Spearman linear correlation analysis showed that there was a positive correlation between serum CXCL-10 and IL-27 levels and SSI score in the observation group (r=0.317 and 0.368,P=0.002 and 0.000). ROC curve analysis showed that the area under curve (AUC) of serum CXCL-10, IL-27 and their combination in the diagnosis of CDI diarrhea were 0.846, 0.853 and 0.874 respectively, the diagnostic sensitivity was 85.25%, 80.30% and 82.75% respectively, and the diagnostic specificity was 78.50%, 82.55% and 85.85% respectively. Conclusion: Serum CXCL-10 and IL-27 can help judge the severity of diarrhea in patients with Clostridium difficile infection, which has clinical application value.
[1] Del Prete R,Ronga L,Addati G,et al.Clostridium difficile.A review on an emerging infection[J].Clin Ter,2019,170(1):e41~e47. [2] Czepiel J,Drozdz M,Pituch H,et al.Clostridium difficile infection:review[J].Eur Clin Microbiol Infect Dis,2019,38(7):1211~1221. [3] 钱娇,许春燕,田发霞,等.艰难梭菌感染的危险因素分析[J].中国卫生检验杂志,2020,30(21):2679~2681. [4] Velazquez G I,Rocha R R,Toro D H,et al.A severity score index for clostridium difficile infection[J].Infect Dis Clin Pract,2008,16(6):376~378. [5] 胡莹,曾珍,单斌.《中国成人艰难梭菌感染诊断和治疗专家共识》解读[J].西部医学,2020,32(1):5~8. [6] 程敬伟,刘文恩,马小军,等.中国成人艰难梭菌感染诊断和治疗专家共识[J].协和医学杂志,2017,8(Z1):131~138. [7] Seman BG,Vance JK,Rawson TW,et al.Elevated levels of interleukin-27 in early life compromise protective immunity in a mouse model of gram-negative neonatal sepsis[J].Infect Immun,2020,88(3):e828~e919. [8] 王丽芳.IL-27在艰难梭菌肠道感染中的免疫作用及机制研究[D].重庆医科大学,2017. [9] 吴夏楠.IL-27调控LL-37/CRAMP表达在艰难梭菌肠道感染中的免疫保护作用及机制研究[D].重庆医科大学,2020. [10] Li LX,Xia YT,Sun XY,et al.CXCL-10/CXCR3 in macrophages regulates tissue repair by controlling the expression of Arg1,VEGFa and TNFα[J].J Biol Regul Homeost Agents,2020,34(3):987~999. [11] Calabriso N,Massaro M,Scoditti E,et al.Phenolic extracts from whole wheat biofortified bread dampen overwhelming inflammatory response in human endothelial cells and monocytes:major role of VCAM-1 and CXCL-10[J].Eur Nutr,2020,59(6):2603~2615. [12] Palucci I,Battah B,Salustri A,et al.IP-10 contributes to the inhibition of mycobacterial growth in an ex vivo whole blood assay[J].Int Med Microbiol,2019,309(5):299~306. [13] Bruce KE,Rued BE,Tsui HT,et al.The opp (AmiACDEF) oligopeptide transporter mediates resistance of serotype 2 streptococcus pneumoniae D39 to Killing by chemokine CXCL10 and other antimicrobial peptides[J].Bacteriol,2018,200(11):e745~e817.
2022, Vol. 28 
冀公网安备13080202000677号