重症肺炎患者诱导痰与血浆炎症介质水平变化  

Changes of Inflammatory Mediators of Induced Sputum and Plasma in Patients with Severe Pneumonia

作　　者：唐朝霞[1] 吴健锋[1] 蔡常洁[1] 陈娟[1] 欧阳彬[1] 陈敏英[1] 管向东[1] 曾勉[2] 

机构地区：[1]中山大学附属第一医院SICU,广东广州510080 [2]中山大学附属第一医院MICU,广东广州510080

出　　处：《按摩与康复医学》2014年第11期42-45,共4页Chinese Manipulation and Rehabilitation Medicine

摘　　要：目的：观察重症肺炎患者诱导痰与外周血的炎症介质水平变化，探讨其局部与全身炎症反应状态。方法：留取66例行有创机械通气的重症肺炎患者入组第1、4、7天及出院或死亡当天的外周静脉血及诱导痰标本，测定标本sTREM-1、TNF-α、IL-10水平；根据预后将患者分为存活组（31例）与死亡组（35例），观察两组血浆与诱导痰的sTREM-1、TNF-α及IL-10水平变化趋势。结果：死亡组诱导痰及血浆sTREM-1、TNF-α、IL-10水平均高于存活组（P〈0.05）；随着时间推移，存活组血浆及诱导痰sTREM-1、TNF-α、IL-10水平呈下降趋势，而死亡组水平均保持高值甚至进一步升高。结论：重症肺炎患者存在全身及气道局部的过度炎症反应，可以诱导痰及血浆sTREM-1、TNF-α、IL-10水平判断患者预后。Objective：To observe the changes of inflammatory mediators in induced sputum and plasma of patients with severe pneumonia and ex-plore the state of local and systematic inflammatory response in severe pneumonia. Methods：Peripheral blood and induced sputum were collectted on days 1, 4, 7 and the day of discharge or death of 66 pneumonia patients with invasive mechanical ventilation. The induced sputum and plasma lev-els of sTREM-1, TNF-αand IL-10 were determined. The subjects were divided into two groups according to the prognosis, such as survivors and non-survivors in severe pneumonia. Results：Plasma induced sputum and levels of sTREM-1, IL-10 and TNF-αin non-survivors were all higher than survivors （P〈0.05）. Induced sputum and plasma sTREM-1, TNF-αand IL-10 levels were gradually decreased in survivors, but maintained at higher levels even further increased in non-survivors. Conclusions：There are excessive inflammatory response of local and systematic in patients with se-vere pneumonia, which probably can be used to judge the prognosis of patients by sTREM-1, TNF-αand IL-10 levels.

关 键 词：重症肺炎 炎症介质 痰 血浆 预后 

分 类 号：R563.11[医药卫生—呼吸系统]