Correlation between serum inflammatory response and stress hormone and immune response in patients with postoperative infection of cesarean section

doi:10.3877/cma.j.issn.1674-1358.2019.01.014

Abstract

Abstract:

Objective

To investigate the correlation between serum inflammatory response and stress hormone and immune response in patients with postoperative cesarean section infection.

Methods

Total of 65 cases of cesarean section complicated with postoperative incision infection from Chongqing City State District People’s Hospital from December 2015 to December 2017 were selected as observation group, while 116 women who underwent cesarean section in our hospital but without wound infection after operation were selected as control group. Total of 5 ml cubital venous blood of the two groups were collected, then the supernatant was collected after centrifugation. The serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), interleukin-8 (IL-8), angiotensin Ⅱ (AT-Ⅱ), cortisol (Cor), insulin (INS) and norepinephrine (NE) were detected by ELISA; the content of CD16⁺CD25⁺ NK cells, CD3⁺CD4⁺ T cells and CD3⁺CD8⁺ T cells were detected by flow cytometry. The immunoadhesive promoting factor (FEER), the direct tumor erythrocyte rosette rate (DTER), immunoadhesive inhibitor (FEIR), tumor red blood cell garland (ATER) and natural tumor red blood cell rosette rate (NTER) count were observed under oil microscope.

Results

The serum levels of IL-6, IL-1, IL-8 and TNF-α of cases in observation group were higher than those of the control group, with significant differences (t = 9.057, 6.432, 8.746, 15.072; P = 0.002, 0.005, 0.001, 0.001). The count of serum CD16⁺CD25⁺ NK cells and CD3⁺CD4⁺ T cells of cases in observation group were significantly lower than those of the control group (t = 3.147, 6.382; P = 0.026, 0.001), and the serum CD3⁺CD8⁺ T cells were significantly higher than that of control group (t = 10.453, P = 0.008). Pearson correlation analysis showed that serum IL-8, IL-6, IL-1 and TNF-α levels in the observation group were positively correlated with serum CD3⁺CD8⁺ T cells and FEIR levels, and counts of CD16⁺CD25⁺ NK, CD3⁺CD4⁺ T cells; but negatively correlated with the contents of FEER, DTER, NTER, ATER, AT-II, Cor, INS and NE.

Conclusions

The inflammatory response in cesarean section infection can significantly activate the excessive secretion of inflammatory factors, and its abnormal activation of inflammatory response and immune response changes, stress hormone secretion is closely related.

Key words: Cesarean section, Wound infection, Inflammatory factor, Stress hormone, Immune response

Ming Li, Xu Pan. Correlation between serum inflammatory response and stress hormone and immune response in patients with postoperative infection of cesarean section[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(01): 70-75.

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References 25

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指标	观察组（46组）	对照组（116组）	t值	P值
IL-6（pg/ml）	8.25 ± 1.61	8.38 ± 1.59	0.034	0.641
IL-1（ng/ml）	4.29 ± 1.09	4.33 ± 1.13	0.069	0.712
IL-8（pg/ml）	6.58 ± 1.49	6.60 ± 1.52	0.035	0.861
TNF-α（ng/ml）	33.26 ± 4.96	33.17 ± 4.35	0.103	0.514
CD16⁺CD25⁺ NK细胞（%）	3.31 ± 0.26	3.29 ± 0.31	0.028	0.893
CD3⁺CD4⁺ T细胞（%）	41.09 ± 5.32	40.86 ± 5.26	0.114	0.685
CD3⁺CD8⁺ T细胞（%）	17.33 ± 3.46	17.28 ± 3.51	0.046	0.552
FEER（%）	60.09 ± 4.68	61.23 ± 4.99	0.267	0.369
DTER（%）	16.33 ± 2.06	16.41 ± 1.97	0.067	0.473
FEIR（%）	28.39 ± 3.77	29.62 ± 3.83	0.367	0.415
NTER（%）	2.41 ± 0.19	2.55 ± 0.23	0.072	0.608
ATER（%）	49.26 ± 5.28	50.03 ± 4.99	0.114	0.527
AT-Ⅱ（pg/ml）	51.36 ± 5.02	52.40 ± 4.32	0.261	0.385
Cor（ng/ml）	186.29 ± 15.38	179.31 ± 16.40	0.397	0.401
INS（U/ml）	9.06 ± 1.36	9.33 ± 1.25	0.108	0.362
NE（ng/ml）	60.07 ± 9.86	59.38 ± 10.47	0.139	0.416

指标	观察组（46组）	对照组（116组）	t值	P值
IL-6（pg/ml）	8.25 ± 1.61	8.38 ± 1.59	0.034	0.641
IL-1（ng/ml）	4.29 ± 1.09	4.33 ± 1.13	0.069	0.712
IL-8（pg/ml）	6.58 ± 1.49	6.60 ± 1.52	0.035	0.861
TNF-α（ng/ml）	33.26 ± 4.96	33.17 ± 4.35	0.103	0.514
CD16⁺CD25⁺ NK细胞（%）	3.31 ± 0.26	3.29 ± 0.31	0.028	0.893
CD3⁺CD4⁺ T细胞（%）	41.09 ± 5.32	40.86 ± 5.26	0.114	0.685
CD3⁺CD8⁺ T细胞（%）	17.33 ± 3.46	17.28 ± 3.51	0.046	0.552
FEER（%）	60.09 ± 4.68	61.23 ± 4.99	0.267	0.369
DTER（%）	16.33 ± 2.06	16.41 ± 1.97	0.067	0.473
FEIR（%）	28.39 ± 3.77	29.62 ± 3.83	0.367	0.415
NTER（%）	2.41 ± 0.19	2.55 ± 0.23	0.072	0.608
ATER（%）	49.26 ± 5.28	50.03 ± 4.99	0.114	0.527
AT-Ⅱ（pg/ml）	51.36 ± 5.02	52.40 ± 4.32	0.261	0.385
Cor（ng/ml）	186.29 ± 15.38	179.31 ± 16.40	0.397	0.401
INS（U/ml）	9.06 ± 1.36	9.33 ± 1.25	0.108	0.362
NE（ng/ml）	60.07 ± 9.86	59.38 ± 10.47	0.139	0.416

组别	例数	IL-6（pg/ml）	IL-1（ng/ml）	IL-8（pg/ml）	TNF-α（ng/ml）
观察组	46	23.02 ± 1.28	9.40 ± 1.09	18.42 ± 1.64	182.09 ± 5.21
对照组	116	8.79 ± 1.31	4.31 ± 1.12	6.60 ± 1.53	36.47 ± 5.04
t值	?	9.057	6.432	8.746	15.072
P值	?	0.002	0.005	0.001	0.001

组别	例数	IL-6（pg/ml）	IL-1（ng/ml）	IL-8（pg/ml）	TNF-α（ng/ml）
观察组	46	23.02 ± 1.28	9.40 ± 1.09	18.42 ± 1.64	182.09 ± 5.21
对照组	116	8.79 ± 1.31	4.31 ± 1.12	6.60 ± 1.53	36.47 ± 5.04
t值	?	9.057	6.432	8.746	15.072
P值	?	0.002	0.005	0.001	0.001

组别	例数	CD16⁺CD25⁺ NK细胞	CD3⁺CD4⁺ T细胞	CD3⁺CD8⁺ T细胞
观察组	46	1.78 ± 0.54	33.01 ± 5.65	29.41 ± 3.65
对照组	116	3.79 ± 0.58	42.12 ± 5.89	17.29 ± 3.51
t值	?	3.147	6.382	10.453
P值	?	0.026	0.001	0.008

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