慢性阻塞性肺疾病伴肺炎患者中血清IL-6、TNF-α、AAG检测价值比对研究  

Forecast Value of Serum Level of IL-6,TNF-α,AAG in Patients with A Combination of COPD and Pneumonia

作　　者：鲍舟君[1] 王晔恺[1] 李翊卫[1] 姚燕珍[1] 安明和[1] 方国安[1] 

机构地区：[1]浙江省舟山医院,316004

出　　处：《医学研究杂志》2012年第6期137-140,共4页Journal of Medical Research

摘　　要：目的探讨白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、α1-酸性糖蛋白(α1-acidglycoprottin,AAG)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)伴肺炎中的表达变化和诊断价值。方法选取2009年9月～2010年9月笔者医院患者72例,健康对照19例,按COPD无、缓解期、急性加重期和肺炎有、无两种因素组合分为6组,酶联免疫吸附试验检测其血清IL-6、TNF-α、AAG含量,双因素协方差分析其差异,并用ROC曲线比较评估其在肺炎中的价值。结果 COPD疾病进展中IL-6、TNF-α、AAG存在升高,并且肺炎患者高于未伴肺炎患者,差异具有显著统计学意义(P<0.01或P<0.05)。ROC曲线显示:TNF-α曲线下面积(AUC)(0.928,95%可信区间为0.869～0.987)和IL-6的AUC(0.928,95%可信区间为0.875～0.982)均高于AAG的AUC(0.719,95%可信区间为0.606～0.833),但TNF-α的Youden指数最高。结论 COPD患者中,TNF-α是相对于IL-6和AAG诊断肺炎的较佳指标。Objective To investigate the relationships between serum levels of interleukin - 6 （ IL - 6）, tumor necrosis factor - α （TNF- α）,α1 -acidglycoprottin（AAG） and disease of combination of chronic obstructive pulmonary disease （COPD） and pneumonia. Methods From September 2009 to September 2010, 72 patients and 19 heahhy individuals were selected and divided into 6 groups by 2 factors：pneumonia and COPD. Serum levels of IL- 6, TNF-α, AAG were detected by enzymelinked immunosorbentassy（ELISA）. The forecast value of pneumonia were analyzed by receiver operator characteristic（ROC） curve. Results Serum levels of IL - 6, TNF -α, AAG increased not only in the progress of COPD（ P 〈 0.01 or P 〈 0.05 ） but also in patients with pneumonia compared to patients without pneumonia（ P 〈 0.01 ）. The area under receiver characteristic curves （ AUC ） of serum levels of IL - 6 （0. 928,95% C10. 875 - O. 982 ） and TNF -α （0. 928,95% CI 0. 869 - O. 987 ） was higher than the AUC of serum levels of AAG （0. 719,95% CI 0. 606 - 0. 833 ） and SAA （0. 853,95 % CI 0. 768 - 0. 937 ） , and the Youden index of TNF - α was highest. Conclusion The present data reveale that serum level of TNF -α is of great value for pneumonia in patients with COPD.

关 键 词：慢性阻塞性肺疾病 肺炎 炎性因子 受试者工作特征曲线 

分 类 号：R[医药卫生]