炎症因子在卒中相关肺炎早期诊断及病情评估中的应用价值  

Application value of inflammatory factors for early diagnosis and severity assessment of stroke-associated pneumonia

作　　者：陈榆 李通[1] 王成志[1] 阮贞[1] CHEN Yu;LI Tong;WANG Cheng-zhi;RAN Zhen(Department of Neurology,the Second People′s Hospital of Nanning,Nanning 530000,China)

机构地区：[1]广西南宁市第二人民医院神经内科

出　　处：《广西医学》2019年第9期1105-1108,共4页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(Z20170115)

摘　　要：目的 探讨白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)在卒中相关肺炎早期诊断及病情评估中的应用价值。方法纳入63例脑卒中患者,分为并发生肺炎组38例,无肺炎组25例。并发肺炎患者中,重症肺炎17例,轻症肺炎21例。于确诊当日、确诊后第3天及第7天测定患者血清IL-10、TNF-α水平。分析合并肺炎的脑卒中患者血清IL-10、TNF-α水平与肺炎严重指数(PSI)的关系。采用受试者工作特征曲线评价确诊后第7天IL-10、TNF-α诊断卒中相关肺炎的临床价值。结果并发肺炎组患者血清IL-10、TNF-α水平高于无肺炎组(均P<0.05),重症肺炎组血清IL-10、TNF-α水平高于轻症肺炎组(均P<0.05)。并发肺炎组患者确诊当日、确诊后第3天、确诊后第7天,血清IL-10水平与PSI均呈正相关(均P<0.05),确诊当日、确诊后第3天,血清TNF-α水平与PSI均呈正相关(均P<0.05)。IL-10、TNF-α诊断卒中相关肺炎的曲线下面积分别为0.846、0.783,灵敏度分别为96.83%、92.44%,特异度分别为88.34%、86.75%。结论血清IL-10、TNF-α水平可作为早期诊断卒中相关肺炎及病情评估的指标。Objective To investigate the application value of interleukin 10 (IL-10) and tumor necrosis factor α(TNF-α) for early diagnosis and severity assessment of stroke-associated pneumonia. Methods Sixty-three stroke patients enrolled were divided into concurrent pneumonia group( n =38) and non-pneumonia group( n =25).Patients complicated with pneumonia included 17 cases of severe pneumonia and 12 of mild pneumonia.Serum IL-10 and TNF-α levels of the patients were determined on the right day of getting the definite diagnosis,day 3 and day 7 after getting the definite diagnosis.The relationship of serum IL-10 or TNF-α with pneumonia severity index(PSI) was analyzed in stroke patients complicated with pneumonia.Receiver operating characteristic curve was used to evaluate the clinical value of IL-10 or TNF-α for diagnosing stroke-associated pneumonia on day 7 after getting the definite diagnosis. Results The levels of serum IL-10 and TNF-α in the concurrent pneumonia group were higher than those in the non-pneumonia group(all P <0.05),the severe pneumonia group had higher serum IL-10 and TNF-α levels than the mild pneumonia group(all P <0.05). On the right day of getting the definite diagnosis,day 3 and day 7 after getting the definite diagnosis,serum IL-10 level positively correlated with PSI among patients complicated with pneumonia(all P <0.05),moreover,serum TNF-α level positively correlated with PSI on the right day of getting the definite diagnosis,and day 3 after getting the definite diagnosis(all P <0.05).The areas under the curve of IL-10 and TNF-α for diagnosing stroke-associated pneumonia were 0.846 and 0.783,respectively,the sensitivities were 96.83% and 92.44%,respectively,and the specificities were 88.34% and 86.75%,respectively. Conclusion Serum IL-10 and TNF-α levels can serve as indicators for early diagnosis and severity assessment of stroke-associated pneumonia.

关 键 词：卒中相关肺炎 缺血性脑卒中 白细胞介素10 肿瘤坏死因子Α 诊断 病情评估 

分 类 号：R743.3[医药卫生—神经病学与精神病学]