脓胸患者胸腔积液中NETs标志物与白细胞及中性粒细胞的相关性研究

石丽璐; 黄载中; 魏莫璐宇; 卿草; 黄文慧; 王可

doi:10.16766/j.cnki.issn.1674-4152.004442

脓胸患者胸腔积液中NETs标志物与白细胞及中性粒细胞的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.004442

广西医科大学第一附属医院呼吸与危重症医学科，广西南宁 530021

基金项目:

国家自然科学基金项目 82260023

广西自然科学基金项目 2022GXNSFAA035646

详细信息

通讯作者:
王可，E-mail: 497256113@qq.com

中图分类号: R561.6 R446.11
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出版历程
- 收稿日期: 2025-07-12

Clinical analysis of NETs biomarkers and their relationship with leukocytes and neutrophils in empyema-associated pleural effusion

Department of Respiratory and Critical Care, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China

摘要

摘要: 目的探究脓胸患者胸腔积液中性粒细胞胞外诱捕网(NETs)生物标志与白细胞、中性粒细胞以及炎症指标C反应蛋白(CRP)之间的相关性，为临床脓胸患者的诊治提供参考。方法收集2017年6月—2021年6月广西医科大学第一附属医院呼吸与危重症医学科三病区脓胸患者资料，无菌采集胸腔积液样本，严格筛选后纳入38例样本及临床数据。采用酶联免疫吸附试验(ELISA)检测胸腔积液NETs标志物水平，汇总数据并进行统计学分析。结果 38例脓胸患者胸腔积液样本中，白细胞、中性粒细胞、C反应蛋白和NETs生物标志物水平均呈现升高的趋势。瓜氨酸化组蛋白H3(citH3)浓度为14.63(0.99, 21.45)ng/mL，胞外DNA(eDNA)浓度为14.09(3.22, 21.93)ng/μL，白细胞计数为(15.08±8.15)×10⁹/L，中性粒细胞计数为[12.04(7.57, 17.99)]×10⁹/L，C反应蛋白为100.50(44.63, 187.00)mg/L；其中胸腔积液微生物培养阳性组citH3浓度为19.12(0.37, 21.23)ng/mL，eDNA浓度为13.15(4.48, 19.62)ng/μL，白细胞计数为(15.58±5.23) ×10⁹/L，中性粒细胞计数为[14.92(12.21, 16.73)]×10⁹/L，C反应蛋白为147.00(103.50, 189.75)mg/L。Spearman相关性分析显示，微生物培养阳性胸腔积液组的citH3水平与白细胞计数、中性粒细胞计数相关(r=0.833、0.867，P＜0.05)，其余各组指标间未发现显著相关性。结论 eDNA、citH3与白细胞、中性粒细胞及C反应蛋白密切相关，可在一定程度上有效评估脓胸的炎症水平与疾病进展。
- 脓胸 /
- 中性粒细胞胞外诱捕网 /
- 白细胞 /
- 中性粒细胞
Abstract: Objective To investigate the correlation between neutrophil extracellular traps (NETs) in pleural fluid and leukocytes, neutrophils, and the inflammatory marker C-reactive protein (CRP) in patients with empyema, in order to provide references for clinical diagnosis and treatment. Methods Clinical data were collected from patients with pyothorax admitted to the Third Ward of the Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Guangxi Medical University, from June 2017 to June 2021. Pleural effusion samples were collected under sterile conditions, and 38 eligible samples along with corresponding clinical data were included after rigorous screening. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of NETs markers in pleural effusion, and all data were summarized and statistically analyzed. Results The data showed a trend of elevated leukocytes, neutrophils, and NETs biomarkers were observed in 38 pleural fluid samples. The concentration of citrullinated histone H3 (citH3) was 14.63(0.99, 21.45) ng/mL, and extracellular DNA (eDNA) 14.09(3.22, 21.93) ng/μL. The leukocytes count was (15.08±8.15)×10⁹/L, the count of neutrophils was [12.04(7.57, 17.99)]×10⁹/L, and CRP level was 100.50(44.63, 187.00) mg/L. In the group with positive pleural fluid microbial cultures, the concentrations were as follows: citH3 at 19.12(0.37, 21.23)ng/mL, eDNA at 13.15(4.48, 19.62)ng/μL, white blood cell count at (15.58±5.23)×10⁹/L, neutrophil count at [14.92(12.21, 16.73)]×10⁹/L, and C-reactive protein level at 147.00(103.50, 189.75) mg/L. Spearman correlation analysis revealed that, in the microbial culture-positive pleural fluid group, citH3 levels were highly correlated with both leukocytes count and neutrophil count (r=0.833, 0.867, P < 0.05). No other significant correlations were observed among the remaining indicators across the groups. Conclusion NET biomarkers, particularly eDNA and citH3, are associated with white blood cells, neutrophils, and C-reactive protein, and may serve as potential indicators for assessing inflammatory severity and disease progression in empyema.
- Empyema /
- Neutrophil extracellular traps /
- Leukocytes /
- Neutrophils
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表 1 胸腔积液样本微生物培养阴性组及阳性组各指标情况

Table 1. Comparison of indicators between culture-negative and culture-positive groups of pleural fluid samples

组别	例数	eDNA[M(P₂₅, P₇₅, ng/μL]	citH3[M(P₂₅, P₇₅, ng/mL]	白细胞($\bar{x} \pm s$，×10⁹/L)	中性粒细胞[M(P₂₅, P₇₅, 10⁹/L]	C反应蛋白[M(P₂₅, P₇₅, mg/L]
阴性组	29	16.72(3.09, 22.52)	14.59(1.10, 21.50)	14.94±7.54	10.04(7.46, 18.14)	68.65(35.25, 185.75)
阳性组	9	13.15(4.48, 19.62)	19.12(0.37, 21.23)	15.58±5.23	14.92(12.21, 16.73)	147.00(103.50, 189.75)
注：白细胞正常值范围为(3.50~9.50)×10⁹/L，中性粒细胞正常值范围(1.80~6.30)×10⁹/L，C反应蛋白正常值范围为0.00~10.00 mg/L。

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