糖皮质激素治疗对大叶性肺炎患者血清中IL-6、TNF-α和IL-8含量的影响  

Effect of glucocorticoid therapy on serum levels of IL-6, TNF-α and IL-8 in patients with lobar pneumonia

作　　者：宋昱晨[1] 朱丹[2] 

机构地区：[1]浙江省金华市人民医院呼吸内科,浙江金华321000 [2]浙江省金华市中心医院呼吸内科,浙江金华321003

出　　处：《中国现代医生》2017年第11期1-4,共4页China Modern Doctor

基　　金：浙江省医药卫生一般研究计划(2014KYB295)

摘　　要：目的探讨糖皮质激素在大叶性肺炎(acute myocardial infarction)治疗中对白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)和肿瘤坏死因子-ɑ(tumor necrosis factor-α,TNF-α)的影响。方法选取2013年5月~2015年4月我院呼吸内科收治的大叶性肺炎患者80例作为研究对象,根据随机数字表法将其分为观察组40例(静脉注射头孢呋辛2.25 g/次,2次/d,联合静脉注射甲泼尼松40 mg/次,1次/d)、对照组40例(静脉注射头孢呋辛2.25 g/次,2次/d)。分别于治疗前、治疗后3 d、治疗后5 d测定两组患者IL-6、IL-8和TNF-α水平。结果治疗前两组患者血清IL-6、IL-8和TNF-α水平比较无统计学差异(P均>0.05);与治疗前相比较,治疗后3 d观察组IL-6、IL-8和TNF-α水平显著降低(P均<0.05),治疗后5 d两组患者IL-6、IL-8和TNF-α水平均较治疗前显著下降(P均<0.05),但观察组下降程度显著大于对照组(P<0.05)。治疗后3 d观察组研究对象的WBC、NEUT含量均明显低于对照组,差异有统计学意义(P<0.05);观察组的PaO_2值明显高于对照组,差异有统计学意义(P<0.05)。治疗后5 d,两组研究对象血液中WBC、NEUT含量差异不显著(P>0.05),但观察组的PaO_2值明显高于对照组,差异有统计学意义(P<0.05)。结论糖皮质激素联合抗生素治疗大叶性肺炎可更有效地降低患者血清IL-6、IL-8和TNF-α水平,利于改善患者预后。Objective To investigate the effect of glucocorticoid therapy on interleukin-6（IL-6）, intedeukin-8（IL-8） and tumor necrosis factor-α（TNF-α） in the treatment of lobar pneumonia. Methods 80 patients with lobar pneumonia treated in the Department of Respiratory Medicine of our hospital from May 2013 to April 2015 were enrolled in this study. The patients were into observation group（n=40） and control group（n=40）. The observation group was treated with intravenous cefuroxime 2.25 g/time, 2 times/d combined with intravenous methylprednisolone 40 mg/time, one time/d, and the control group was given intravenous cefuroxime 2.25 g/time, two times/d. The levels of IL-6, IL-8 and TNF-α in two groups were measured before treatment and after 3 days and 5 days of treatment. Results There was no significant difference in serum IL-6, IL-8 and TNF-α between the two groups before treatment（P〉0.05）. The levels of IL-6 and IL-8 and TNF-α in the observation group after 3 days of treatment were significantly lower than those before treatment（P〈 0.05）. The levels of IL-6, IL-8 and TNF-α in the two groups after 5 days of treatment were significantly lower than those before treatment（P〈0.05）, but the degree of decline in the observation group was significantly greater than that in the control group（P〈0.05）. The levels of WBC and NEUT in the observation group were significantly lower than those in the control group at 3 days after treatment, and the difference was significant（P〈0.05）. The PaO2 value of the observation group was significantly higher than that of the control group, and the difference was statistically significant（P〈0.05）. There was no significant difference in WBC and NEUT between the two groups at 5 days after treatment（P〉O.05）. But the PaO2 value in the observation group was significantly higher than that in the control group,and the difference was statistically significant（P〈0.05）. Conclusion Glucocorticoid combined with antibiotics in the treatment

关 键 词：大叶性肺炎 白细胞介素-6 肿瘤坏死因子-Α 白细胞介素-8 

分 类 号：R563.11[医药卫生—呼吸系统]