血清IL-6、IL-8和TNF-α在胆道术后感染监测中的价值  

Diagnostic Value of Serum IL-6,IL-8 and TNF-α in Monitoring Inflammation After Operation of Biliary Tract Infection

作　　者：姚燕珍[1] 鲍舟君[1] 张晓帮[1] 安明和[1] 方国安[1] 

机构地区：[1]浙江省舟山医院检验科,316004

出　　处：《医学研究杂志》2012年第4期104-106,共3页Journal of Medical Research

基　　金：舟山市医药卫生科技计划资助项目(2009B06)

摘　　要：目的探讨白介素-6(interleukin-6,IL-6)、白介素-8(interleukin-8,IL-8)和肿瘤坏死因子-α(tumor necro-sis factor-α,TNF-α)等细胞因子在胆道术后感染监测中的价值。方法选取35例胆汁细菌培养阳性的胆道感染患者作为实验组、选取40例细菌性肺炎作为细菌性感染对照组、21例病毒性肝炎患者作为病毒性感染对照组,以及19例健康个体作为正常对照组,分别抽取空腹静脉血3ml,定量检测血清IL-6、IL-8和TNF-α的水平,对3者在各组间的差异、以及在鉴别细菌性感染与非细菌性感染中的价值进行统计学分析。结果 IL-6、IL-8和TNF-α在胆道感染和细菌性肺炎组均明显高于病毒性肝炎和正常对照组(P<0.01),其中IL-6和IL-8在胆道感染和细菌性肺炎组间均无统计学意义上的差异(P>0.05)、TNF-α在细菌性肺炎组较高(t=4.253,P<0.01)。TNF-α在病毒性肝炎和正常对照组间无统计学意义上的差异(P>0.05)、IL-6和IL-8则在病毒性肝炎组中较高(P<0.05)。当IL-6测定值>17.4pg/ml时,鉴别细菌性和非细菌性感染的灵敏度和特异度分别为93.3%和77.5%;IL-8测定值>102.1pg/ml时,分别为89.3%和87.5%,TNF-α测定值大于104.5pg/ml时,分别为100%和97.5%。结论胆道感染时,血清IL-6、IL-8和TNF-α均显著增高,其中以TNF-α在术后炎症监测中的价值最高。Objective To investigate the diagnostic value ol serum IL -6,1L -8 and TNF -α in monitoring inflammation after operation of biliary tract infection. Methods The serum level of IL - 6, IL - 8 and TNF -αwere detected in a group of 35 patients of biliary tract infection with positive bile bacterial culture, and three control groups of 40 patients with bacterial pneumonia, of which 21 patients with virus hepatitis and 19 cases of health individuals. The difference of three cytokines＇ level among four groups, and their values of differential diagnosis between bacterial and non - bacterial infection were analyzed statistically. Results IL - 6, IL - 8 and TNF -α were significantly increased in biliary tract infection and bacterial pneumonia, when compared with virus hepatitis and health individuals（ P 〈 0.01 ）. The levels of IL - 6 and IL - 8 in biliary tract infection had no difference from bacterial pneumonia（ P 〉 0.05 ） , while TNF -α increased in bacterial pneumonia（ t = 4. 253, P 〈 O. 01 ）. In virus hepatitis and health individuals, TNF -α had no difference （ P 〉 0.05 ） , while IL -6 and IL -8 increased in virus hepatitis （P 〈 0.05 ）. When Youden index got the maximal value, the sensitivity and specificity of IL-6,IL-8 and TNF -α in distinguishing bacterial from non -bacterial infection were 93.3% and 77.5% ,89.3% and 87.5% , 100% and 97.5% , respectively. Conclusion IL - 6, IL - 8 and TNF -α will rise up significantly in serum after operation of biliary tract infection. Three cytokines my be helpful in monitoring bacterial infection, but TNF -α is better in sensitivity and specificity.

关 键 词：胆道感染 细胞因子 白介素 肿瘤坏死因子 

分 类 号：R581.1[医药卫生—内分泌]