继发性肺结核伴呼吸衰竭患者外周血炎性标志物水平变化及其临床意义  

Value of plasma inflammatory biomarkers in secondary pulmonary tuberculosis patients with acute respiratory failure

作　　者：刘秋月[1] 骆宝建[1] 韩芬[1] 李琦[2] LIU Qiu-yue;LUO Bao-jian;HAN Fen;LI Qi(Intensive Care Unit,Beijing Chest Hospital,Capital Medical University,Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149,China;Department of Tuberculosis,Beijing Chest Hospital,Capital Medical University,Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京胸科医院ICU,北京市结核病胸部肿瘤研究所,北京101149 [2]首都医科大学附属北京胸科医院结核科,北京市结核病胸部肿瘤研究所,北京101149

出　　处：《中国医刊》2020年第1期39-42,共4页Chinese Journal of Medicine

基　　金：北京市医院管理中心“青苗”计划专项经费资助(QML20181603)

摘　　要：目的探讨临床常用外周血炎性标志物在继发性肺结核伴呼吸衰竭中的应用价值。方法选择2017年12月至2019年5月首都医科大学附属北京胸科医院收治并确诊为继发性肺结核的患者129例,其中单纯继发性肺结核(肺结核组)66例,继发性肺结核伴呼吸衰竭(呼吸衰竭组)63例,比较两组患者外周血血浆白细胞介素1家族成员6(interleukin-1 family 6,IL1F6)、超敏C反应蛋白(hypersensitive C-reactive protein,hCRP)、血清降钙素(procalcitonin,PCT)水平及红细胞沉降率(erythrocyte sedimentationrate,ESR)。结果呼吸衰竭组患者的IL1F6、hCRP及PCT水平均明显高于肺结核组,差异有显著性(P<0.05),两组ESR比较差异无显著性(P>0.05)。受试者工作特征曲线分析显示,IL1F6预测肺结核患者是否易发生呼吸衰竭的曲线下面积最高,为0.896,其敏感度为90.0%,特异度为81.0%。PCT预测肺结核患者是否易发生呼吸衰竭的曲线下面积为0.737,其敏感度为77.8%,特异度为68.3%。结论外周血IL1F6及PCT水平对继发性肺结核患者发生呼吸衰竭具有良好的诊断价值。Objective To evaluated the value of IL1F6 and plasma inflammatory biomarkers in secondary pulmonary tuberculosis patients with acute respiratory failure. Method One hundred and twenty-nine cases of patients with secondary pulmonary tuberculosis plasma specimens were enrolled in this study. Patients were divided into secondary pulmonary tuberculosis group and respiratory failure group. The concentrations of interleukin-1 family 6(IL1F6), hypersensitive C reactive protein(hCRP), erythrocyte sedimentation rate(ESR) and procalcitonin(PCT) were tested. Result The level of IL1F6, hCRP and PCT were significantly higher than those in secondary pulmonary tuberculosis group. IL1F6 and PCT was positively related to respiratory failure in patients with pulmonary tuberculosis. ROC analysis showed that AUC of IL1F6 was 0.896, the sensitivity of IL1F6 was 90.0% and specificity was 81.0%. AUC of PCT was 0.737, the sensitivity of PCT was 77.8% and specificity was 68.3%. Conclusion Plasma IL1F6 and PCT have good clinical values in monitoring the respiratory failure in secondary pulmonary tuberculosis patients.

关 键 词：继发性肺结核 白细胞介素1家族成员6 血清降钙素 呼吸衰竭 

分 类 号：R521[医药卫生—内科学]