肺炎衣原体感染对尿毒症患者心血管的影响

Influence of Chlamydia pneumoniae infections on cardiovascularsystem of patients with uremia

  • 摘要: 目的 探究肺炎衣原体感染对尿毒症患者心血管的影响,旨在为临床诊断和治疗提供依据。方法 选取2015年1月-2016年12月于医院接受治疗的106例尿毒症患者为研究对象,其中53例无肺炎衣原体感染的尿毒症患者为对照组,发生肺炎衣原体感染的53例尿毒症患者作为感染组,采用流式细胞仪比较两组患者辅助性T细胞17(TH17)和调节性T细胞(Treg)比例,比较两组患者体内细胞因子IL-17、IL-6和IL-10的浓度,通过心血管测定仪比较两组患者的心搏出量(SV)、每分输出量(CO)、心搏指数(SI)、射血分数(EF)和总外周阻力(TPR)等心功能指标。结果 感染组患者TH17和Treg细胞比例为11.33±5.07,对照组患者为3.99±0.58,感染组患者高于对照组(P<0.05); 感染组患者细胞因子IL-17、IL-6和IL-10的浓度分别为(61.07±11.72)pg/ml、(52.61±10.19)pg/ml和(7.02±3.18)pg/ml,对照组分别为(15.33±5.71)pg/ml、(14.29±3.67)pg/ml和(27.69±5.43)pg/ml,感染组患者细胞因子IL-17和IL-6的浓度高于对照组患者,IL-10的浓度低于对照组患者(均P<0.05); 感染组患者的心功能较对照组患者更差,其SV、CO、SI、EF均低于对照组患者,TPR大于对照组患者(均P<0.05)。结论 尿毒症患者发生肺炎衣原体感染时,其体内TH17和Treg细胞比例失衡,促炎因子IL-17和IL-6浓度上升,抗炎因子IL-10浓度下降,从而导致患者心血管功能发挥失常,对患者的生活产生不利影响。

     

    Abstract: OBJECTIVE To explore the influence of Chlamydia pneumoniae infections on cardiovascular system of patients with uremia so as to provide guidance for clinical diagnosis and treatment. METHODS A total of 106 patients with uremia who were treated in the hospital from Jan 2015 to Dec 2016 were recruited as the study objects, of whom 53 did not have C.pneumoniae infection were assigned as the control group, and the patients who had C.pneumoniae infection were set as the infection group.The proportion of the type 17 helper T (TH17) cells and regulatory T cells (Treg) was compared between the two groups of patients with the use of flow cytometry, the levels of cytokines IL-17, IL-6 and IL-10 were compared between the two groups of patients, indexes such as stroke volume (SV), output per minute (CO), stroke index (SI), ejection fraction (EF) and total peripheral resistance (TPR) were compared between the two groups of patients by means of cardiovascular analyzer. RESULTS The proportion of the TH17 cells and Treg cells was 11.33±5.07 in the infection group, significantly higher than 3.99±0.58 in the control group(P<0.05).The levels of cytokines IL-17, IL-6 and IL-10 were respectively (61.07±11.72)pg/ml, (52.61±10.19)pg/ml and (7.02±3.18)pg/ml in the infection group and were respectively (15.33±5.71)pg/ml, (14.29±3.67)pg/ml and (27.69±5.43)pg/ml in the control group; the levels of cytokines IL-17 and IL-6 of the infection group were significantly higher than those of the control group, the IL-10 level of the infection group was significantly lower than that of the control group(all P<0.05).The cardiac function of the infection group was worse than that of the control group, the SV, CO, SI and EF of the infection group were significantly less than those of the control group, the TPR of the infection group was significantly greater than that of the control group(all P<0.05). CONCLUSION The proportion of the TH17 cells and Treg cells is out of balance in the uremia patients when they have C.pneumoniae infection, the levels of proinflammatory factors IL-17 and IL-6 are elevated, the anti-inflammatory cytokine IL-10 level is reduced, which therefore leads to the cardiovascular dysfunction and has adverse effect on the life of the patients.

     

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