肺泡灌洗液中可溶性血管内皮细胞选择素对成人重症肺炎的诊断价值  

Diagnostic Value of Endothelial Cell Selectin in BALF on Severe Pneumonia in Adult

作　　者：林洁如[1] 贾崇高 曹珊 彭春红[1] 许梅[1] 吴瑞明[1] 陈仁华[1] 曾婷[1] 张湘燕[1] 叶贤伟[1] LIN Jieru;JIA Chonggao;CAO Shan;PENG Chunhong;XU Mei;WU Ruiming;CHEN Renhua;ZENG Ting;ZHANG Xiangyan;YE Xianwei(Department of Respiratory and Critical Care Medicine,Guizhou Provincial People＇s Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院呼吸与危重症医学科,贵州贵阳550002

出　　处：《贵州医科大学学报》2018年第11期1332-1335,共4页Journal of Guizhou Medical University

基　　金：2015年度贵阳市科技计划项目[(筑科合同)20151001社54号];贵州省科技计划(2003JW025)

摘　　要：目的:探讨肺泡灌洗液(BALF)中可溶性血管内皮细胞选择素(s ES)对成人重症肺炎的诊断价值。方法:选择肺炎患者120例,依据病情严重程度分为重症肺炎组(n=60)及非重症肺炎组(n=60),另选与肺炎患者年龄、性别相匹配的非肺炎者60例作为对照组;采用酶联免疫吸附试验(ELISA)检测3组被检者BALF中s ES、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平;绘制受试者工作特征曲线(ROC),判断各指标对成人重症肺炎的诊断价值。结果:与对照组比较,重症肺炎组及非重症肺炎组BALF中s ES、IL-6及TNF-α水平显著升高,差异有统计学意义(P <0. 01);重症肺炎组BALF中s ES、TNF-α水平显著高于非重症肺炎组(P <0. 01),IL-6水平亦高于非重症肺炎组、但差异无统计学意义(P=0. 365); s ES的ROC曲线下面积、敏感性、特异性、阳性似然比均高于IL-6和TNF-α。结论:BALF中的s ES水平可作为成人重症肺炎诊断参考指标之一。Objective：To investigate the diagnostic value of soluble vascular endothelial cell selectin （sES） in bronchoalveolar alveolar lavage fluid （BALF） for severe pneumonia in adult. Methods： 180 patients were included （60 cases of severe pneumonia group, 60 cases of non-severe pneumonia group, and another 60 patients as control group were selected accordingly in age and gender）. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of sES, interleukin-6 and tumor necrosis factor-α in BALF of each group. The receiver operating characteristic curve （ROC） was drawn and used to judge the diagnostic value of each index. Result： The levels of sES, IL-6 and TNF-α in BALF of severe pneumonia group and non-severe pneumonia group were significantly higher than those of control group, differences were statistically significant （ P 〈0.01）. The levels of sES and TNF-α in BALF of severe pneumonia group were higher than those of non-severe pneumonia group （ P 〈0.01）, the level of IL-6 in BALF of severe pneumonia group was higher than that of non-severe pneumonia group, but differences were not statistically significant （ P =0.365）. The ROC curve, sensitivity, specificity, and Youden index of sES were higher than that of IL-6 and TNF-α. Conclusion： The level of sES in BALF could serve as an effective index for severe pneumonia diagnosis in adults.

关 键 词：肺炎 可溶性血管内皮细胞选择素 白细胞介素-6 肿瘤坏死因子-Α 生物标志物 成人 重症 

分 类 号：R563.1[医药卫生—呼吸系统]