ICU重症肺部感染患者血清IL-6、IL-1β、IL-8和TNF-α水平变化及其与预后的关系  

Changes of serum IL-6, IL-1β, IL-8 and TNF-α levels in ICU patients with severe lung infection and their relationship with prognosis

作　　者：任韩雯婧 张川[1] 乐涛[1] 王玺 余红[1] 王婷 贾椸琳 RENHAN Wen-jing;ZHANG Chuan;LE Tao;WANG Xi;YU Hong;WANG Ting;JIA Lu-lin(Intensive Care Unit,Chengdu Third People's Hospital,Chengdu,Sichuan 610000,China)

机构地区：[1]成都市第三人民医院重症监护室,四川成都610000

出　　处：《热带医学杂志》2022年第10期1371-1375,1390,1461,共7页Journal of Tropical Medicine

基　　金：四川省医学会科研项目(2016ZZ002);四川省护理科研课题(H19048)

摘　　要：目的分析重症监护室(ICU)重症肺部感染患者血清白细胞介素-6(IL-6)、IL-1β、IL-8、肿瘤坏死因子-α(TNF-α)水平变化及其与预后的关系。方法选取ICU重症肺部感染者109例为重症肺炎组,同期社区获得性肺炎患者96例为肺炎组,健康体检者45人作为对照组。依据28 d预后分为死亡组、存活组,分析其血清IL-6、IL-1β、IL-8、TNF-α水平及对ICU重症肺部感染、28 d预后的预测价值。结果重症肺炎组入院第1天血清IL-6、IL-1β、IL-8、TNF-α水平高于肺炎组和对照组(F=1479.825、268.294、975.632、804.328,P均<0.05),肺炎组与对照组上述指标比较差异均有统计学意义(P均<0.05)。入院第1天四项联合预测ICU重症肺部感染的曲线下面积(AUC)为0.792,高于IL-6、IL-1β、IL-8、TNF-α单独预测(分别为0.744、0.671、0.734、0.755)。死亡组入院第1、3、7天及7 d内平均血清IL-6、IL-1β、IL-8、TNF-α水平高于存活组(P均<0.05)。入院7 d内平均血清IL-6、IL-1β、IL-8、TNF-α及四项联合检测预测ICU重症肺部感染患者死亡的AUC分别为0.726、0.705、0.657、0.735、0.765。结论ICU重症肺部感染患者血清IL-6、IL-1β、IL-8、TNF-α水平在入院7 d内发生变化,对判断预后有临床价值。Objective To analyze the changes in levels of serum interleukin-6(IL-6),interleukin-1β(IL-1β),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in patients with severe lung infection in intensive care unit(ICU)and their relationship with prognosis.Methods A total of 109 patients with severe lung infection in ICU(severe pneumonia group),96 patients with common community-acquired pneumonia(pneumonia group),and 45 healthy individuals(control group)were enrolled in this study.Patients in severe pneumonia group were divided into death group and survival group according to the 28-day prognosis.The value of serum IL-6,IL-1β,IL-8 and TNF-αlevels in predicting severe lung infection and 28d prognosis was analyzed.Results Serum IL-6,IL-1β,IL-8 and TNF-αlevels in severe pneumonia group on day 1 after admission were higher than those in pneumonia group and control group,and there were statistically significant differences between the pneumonia group and the control group(F=1479.825,268.294,975.632,804.328,all P<0.05).The AUC values of serum IL-6,IL-1β,IL-8,TNF-αalone and in combination to predict severe lung infection were 0.744,0.671,0.734,0.755 and 0.792,respectively.The average levels of serum IL-6,IL-1β,IL-8 and TNF-αat 1,3 and 7 d after admission,and within 7 d after admission in death group were higher than those in survival group(all P<0.05).AUC values of average serum IL-6,IL-1β,IL-8,TNF-αand their combination within 7 d after admission for predicting death of ICU patients with severe lung infection were 0.726,0.705,0.657,0.735 and 0.765,respectively.Conclusion Serum IL-6,IL-1β,IL-8 and TNF-αlevels changed in ICU patients with severe lung infection within 7 d after admission,which might have prognositic values.

关 键 词：重症监护室 重症肺部感染 IL-6 IL-1Β IL-8 TNF-Α 预后 

分 类 号：R563.1[医药卫生—呼吸系统]