CAJ | 학술논문

目的：探讨非粒细胞缺乏侵袭性肺曲霉病（IPA）患者血清中 IL-17、Dectin-1水平的变化及其意义。方法分别收集23例确诊及临床诊断为 IPA 的非粒细胞缺乏患者（IPA 组）、31例临床诊断为肺炎患者（肺炎组）和51例健康体检者（对照组）的资料，应用 ELISA 法测定血清 IL-17含量；同时检测 IPA 组及对照组血清 Dectin-1含量，并测定 IPA 组患者血清 G 试验、GM 试验、外周血白细胞计数和血清 CRP 的水平，随访患者预后，分析血清 IL-17与其相关性。结果IPA 组患者血清 IL-17含量明显高于对照组（P ＜0．05）；肺炎组患者血清 IL-17水平与对照组差异无统计学意义（P ＞0．05）；IPA 组血清 Dectin-1含量明显高于对照组（P ＜0．05）；IPA 组血清 IL-17与 Dectin-1水平呈正相关（r＝0．81，P ＜0．05）；IPA 组血清 IL-17、Dectin-1水平与 G 试验、GM 试验、白细胞、CRP 及患者的预后无相关性（P ＞0．05）。结论非粒细胞缺乏宿主曲霉感染时刺激 Dec-tin-1产生，激活 Th17细胞免疫反应，且两者间存在相关性。
목적：탐토비립세포결핍침습성폐곡매병（IPA）환자혈청중 IL-17、Dectin-1수평적변화급기의의。방법분별수집23례학진급림상진단위 IPA 적비립세포결핍환자（IPA 조）、31례림상진단위폐염환자（폐염조）화51례건강체검자（대조조）적자료，응용 ELISA 법측정혈청 IL-17함량；동시검측 IPA 조급대조조혈청 Dectin-1함량，병측정 IPA 조환자혈청 G 시험、GM 시험、외주혈백세포계수화혈청 CRP 적수평，수방환자예후，분석혈청 IL-17여기상관성。결과IPA 조환자혈청 IL-17함량명현고우대조조（P ＜0．05）；폐염조환자혈청 IL-17수평여대조조차이무통계학의의（P ＞0．05）；IPA 조혈청 Dectin-1함량명현고우대조조（P ＜0．05）；IPA 조혈청 IL-17여 Dectin-1수평정정상관（r＝0．81，P ＜0．05）；IPA 조혈청 IL-17、Dectin-1수평여 G 시험、GM 시험、백세포、CRP 급환자적예후무상관성（P ＞0．05）。결론비립세포결핍숙주곡매감염시자격 Dec-tin-1산생，격활 Th17세포면역반응，차량자간존재상관성。
Objective To explore the changing levels of serumIL-17 and Dectin-1 and their implication in non-neutropenic pa-tients with invasive pulmonary aspergillosis (IPA).Methods The clinical data were reviewed for 23 non-neutropenic patients with clinical diagnosis of IPA (IPA group),31 patients with clinical diagnosis of pneumonia (pneumonia group)and 51 healthy subjects(control group).The peripheral serum was collected to analyze IL-17 level by ELISA.Serum Dectin-1 level was also determined at the same time.Serum G test,GM test,WBC and CRP level were also assayed for the patients in IPA group.Pa-tient outcome was followed up and analyzed in terms of serum IL-17.Results The serum IL-17 level of the patients in IPA group was significantly higher than that in the control group (P <0.05).The serum IL-17 level in the pneumonia group was not significantly different from that in the control group (P >0.05).The serum Dectin-1 level in IPA group was significantly higher than that in the control group (P <0.05).For the patients in IPA group,serum IL-17 level was positively correlated to serum Dectin-1 level (r=0.81 ,P <0.05),while serum IL-17 and Dectin-1 levels were not correlated to the results of G test, GM test, WBC,CRP or patient outcome (P > 0.05 ). Conclusions Dectin-1 may be produced and Th17 cell immunity activated in response to Aspergillus fumigatus in-fection in non-neutropenic patients.And,serum Dectin-1 level is correlated with Th17 response.