探讨外周血IgM、TNF-α、SPA及IL-10表达在院内获得性肺炎患者治疗及预后中的评价影响  

The Significance of the Expression Levels of Peripheral Blood IgM,TNF-α,SPA and IL-10 in the Treatment and Prognosis of Patients with Hospital Acquired Pneumonia

作　　者：吴广江 马颖欣 王泽娟 薛文英 WU Guang-jiang;MA Ying-xin;WANG Ze-juan;XUE Wen-ying(Department of Infection Management,Beijing Century TempleHospital Affiliated to Capital Medical University,Beijing 100038,China;Pharmaceutical Phase I Clinical Trial Laboratory,Beijing Century TempleHospital Affiliated to Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院感染管理处,北京100038 [2]首都医科大学附属北京世纪坛医院药物Ⅰ期临床试验研究室,北京100038

出　　处：《标记免疫分析与临床》2019年第2期181-184,200,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨外周血肺炎支原体抗体(mycoplasma pneumoniae Immunoglobulin M,MP-IgM)、肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、肺表面活性蛋白A(pulmonary surfactant protein A,SPA)及白细胞介素-10(interleukin 10,IL-10)表达在院内获得性肺炎患者治疗及预后中的评价意义。方法选取2016年1月至2017年12月本院确诊的100例院内获得性肺炎患者为观察组给予对症治疗,选取同期健康体检患者50例为对照组。分别检测患者外周静脉血中MP-IgM、TNF-α、SPA及IL-10表达水平。结果与对照组相比,观察组患者血清内TNF-α、SPA及IL-10表达水平显著升高,血清MP-IgM呈明显阳性,随着疾病程度的加重,表现更为明显(P<0.05);观察组血清内TNF-α、SPA及IL-10表达水平治疗后显著降低,血清MP-IgM阳性减少(P<0.05)。院内获得性肺炎患者体内TNF-α、SPA及IL-10含量,MP-IgM阳性率与疾病严重程度存在显著的正性相关关系,P<0.05。经ROC分析可知,MP-IgM、TNF-α、SPA及IL-10这4项生物学标志物并联试验灵敏度为92.00%,串联试验特异性为100.00%,显著大于各单项生物学标志物检测(P<0.05)。结论外周静脉血中MP-IgM、TNF-α、SPA及IL-10表达在院内获得性肺炎患者体内异常升高,给予药物治疗后患者病情缓解,外周静脉血中MP-IgM、TNF-α、SPA及IL-10变化有利于监测在院内获得性肺炎患者的病情程度和治疗,值得推广研究。Objective To investigate the significance of the expression levels of peripheral blood mycoplasma pneumoniae immunoglobulin M (MP-IgM),tumor necrosis factor-α(TNF-α),pulmonary surfactant protein A (SPA),and leukocytes and Interleukin 10 (IL-10)in the treatment and prognosis of patients with hospital acquired pneumonia. Methods A total of 100 patients with hospital acquired nosocomial pneumonia diagnosed in our hospital from January,2016 to December,2017 were selected for the study and undergone symptomatic treatment. 50 healthy subjects were selected as the control group in the same period. The expression levels of MP-IgM,TNF-α,SPA and IL-10 in peripheral blood of all patients were detected. Results Compared with the control group,the levels of serum TNF-α,SPA and IL-10 in the observation group were significantly increased,and the serum MP-IgM showed significantly positive. As the disease level increases,the trend became more pronounced ( P <0.05). The levels of serum TNF-α,SPA and IL-10 in the observation group were significantly decreased after the treatment,and the positive rate of serum MP-IgM was decreased ( P <0.05). There was a significant positive correlation between the positive rate of MP-IgM and the severity of disease in patients with hospital acquired nosocomial pneumonia ( P <0.05). According to ROC analysis,the sensitivity of the four biomarkers of MP-IgM,TNF-α,SPA and IL-10 was 92.00%,and the tandem test specificity was 100.00%,which was significantly greater than that of each single biomarker ( P <0.05). Conclusion The expression levels of MP-IgM, TNF-α,SPA and IL-10 in peripheral venous blood are abnormally elevated in patients with nosocomial pneumonia. The patient′s condition is relieved after the drug treatment,which can be reflected by these markers. The changes of the expression levels of MP-IgM, TNF-α,SPA and IL-10 in peripheral venous blood are beneficial to monitor the severity and treatment efficiency of patients with acquired pneumonia in hospital,which is worthy of deeper re

关 键 词：院内获得性肺炎 MP-IGM TNF-Α SPA IL-10 

分 类 号：R563.1[医药卫生—呼吸系统]