HCY和IL-6水平鉴别呼吸机相关性肺炎和抗生素治疗后的应用  

Application of serum HCY and IL-6 levels in the differential diagnosis of patients with ventilator associated pneumonia after antibacterial drugs

作　　者：郑青[1] 鲍逸民[1] 杨永青[2] 徐莉[3] 

机构地区：[1]南京医科大学附属苏州市立医院本部急诊科,江苏苏州215002 [2]江苏苏州南京医科大学附属苏州市立医院本部核医学科,江苏苏州215002 [3]南京医科大学附属苏州市立医院本部呼吸内科,江苏苏州215002

出　　处：《临床肺科杂志》2015年第12期2217-2219,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的：探讨同型半胱氨酸（homocysteine,HCY）和白介素6（Interleukin 6,IL-6）水平鉴别诊断呼吸机相关性肺炎和抗生素治疗后的应用。方法186例呼吸机相关性肺炎,66例病毒性肺炎患者和80例健康对照组测定了血清HCY和IL-6水平并进行了对比性分析。将186例呼吸机相关性肺炎随机分成5组,在青霉素G,左氧氟沙星,头孢哌酮单独和组合治疗后,血清HCY和IL-6水平考核了呼吸机相关性肺炎的治疗效果。结果186例呼吸机相关性肺炎血清HCY和IL-6水平较之66例病毒性肺炎患者和80例健康对照组显著增高（P均〈0．001）,66例病毒性肺炎患者较之80例健康对照组,无明显差异。在抗生素药物单独或组合治疗后,呼吸机相关性肺炎痊愈者血清HCY和IL-6降至正常水平（ P均〉0．05）,而未痊愈者仍然增高（ P〈0．05-〈0．001）。结论 HCY和IL-6水平具有鉴别诊断呼吸机相关性肺炎和非细菌性感染的临床意义,并是考核抗生素治疗效果的有价值指标。Objective To explore the application of serum HCY and IL-6 levels in the differential diagnosis of patients with ventilator associated pneumonia after antibacterial drugs. Methods The serum levels of HCY and IL-6 were determined in 186 patients with ventilator associated pneumonia, 66 patients with viral pneumonia and 80 controls. The 186 patients with ventilator associated pneumonia were divided into five groups, and the serum levels of HCY and IL-6 were tested to evaluate the curative effect of penicillin G, levofloxacin and cefoperazone alone and combination therapy for patients with ventilator associated pneumonia. Results The serum levels of HCY and IL-6 in 186 patients with ventilator associated pneumonia were significantly higher than those in 66 patients with virus pneumonia and 80 controls （ P 〈0. 001 ） . The serum levels of HCY and IL-6 in 66 patients with 66 virus pneumonia showed no significant difference with the controls （P〉0. 05）. After antibacterial drugs therapy, the serum levels of HCY and IL-6 were normal in patients with clinical convalescence ventilator associated pneumonia （P〉0. 05）, but they still increased in patients with no effectiveness （P〈0. 05-0. 001）. Conclusion HCY and IL-6 levels have the clinical significance on differential diagnosis between ventilator associated pneumonia and non-bacterial infection, and they are also valuable indexes to evaluate the curative effect after antibacterial drugs therapy.

关 键 词：呼吸机相关性肺炎 同型半胱氨酸(HCY) 白介素-6(IL-6) 鉴别诊断 抗生素药物 有价值指标 

分 类 号：R563.1[医药卫生—呼吸系统]