炎症标志物与新型冠状病毒肺炎患者病情程度关系  

Association of inflammatory markers with severity of COVID-19

作　　者：何梅梅 朱义朗[1] 尚晓娟[1] 汪小五 高勇[1] HE Mei-mei;ZHU Yi-lang;SHANG Xiao-juan;WANG Xiao-wu;GAO Yong(Fuyang City Second People’s Hospital,Fuyang 236015,China)

机构地区：[1]阜阳市第二人民医院,安徽阜阳236015

出　　处：《华南预防医学》2020年第3期247-249,253,共4页South China Journal of Preventive Medicine

基　　金：阜阳市科技局应急科技攻关项目(阜科[2020]10号第1项)。

摘　　要：目的探究白细胞介素-6(IL-6)、淀粉样蛋白A(SAA)、降钙素原(PCT)、C反应蛋白(CRP)等炎症标志物与新型冠状病毒肺炎(新冠肺炎)患者病情程度的关系。方法选取安徽省阜阳市某医院2020年1—2月新冠肺炎患者临床资料进行分析,对比重症病例和轻症病例血清IL-6、SAA、PCT、CRP水平,探讨血清IL-6、SAA、PCT、CRP水平对于联合鉴别轻症、重症新冠肺炎的价值及与病情程度关系。结果符合本研究条件的新冠肺炎患者共70例,其中重症肺炎19例(重症组),轻症肺炎患者51例(轻症组)。重症组血清IL-6、SAA、CRP水平均高于轻症组(P<0.05或P<0.01)。血清IL-6、SAA、CRP水平联合鉴别轻症、重症新冠肺炎的曲线下面积(AUC)为0.817,大于各指标单一鉴别,联合鉴别最佳敏感度为78.93%,特异度为80.39%;血清IL-6、CRP水平与新冠肺炎患者病情程度存在正相关关系(P<0.05)。血清IL-6(OR=5.040)、CRP(OR=5.366)水平越高,新冠肺炎病情为重症的可能性越大。结论重症新冠肺炎患者血清IL-6、CRP呈异常高表达状态,与新冠肺炎患者病情程度呈正相关,对鉴别新冠肺炎病情严重程度具有一定辅助价值。Objective To explore the association of inflammatory markers of interleukin-6(IL-6),serum amyloid A(SAA),procalcitonin(PCT),and C-reactive protein(CRP)with the severity of coronavirus disease 2019(COVID-19). Methods Clinical data of patients with COVID-19 from January 2020 to February 2020 in a hospital in Fuyang City,Anhui Province were collected for clinical analysis. Serum levels of IL-6,SAA,PCT,and CRP were compared between the severe and mild cases of COVID-19. The value of serum IL-6,SAA,PCT,and CRP in the identification of mild and severe cases of COVID-19 was explored,and their association with the severity of the COVID-19 were evaluated. Results A total of 70 patients with COVID-19 who met the criteria of this study were enrolled,including 19 cases of severe COVID-19(severe group)and 51 cases of mild one(mild group). Serum levels of IL-6,SAA,and CRP in the severe group were higher than those in the mild group(P<0.05 for all). The area under the curve of serum IL-6,SAA,and CRP combined to identify the mild and severe COVID-19 cases was 0.817,which was greater than the single identification of each index. The optimal sensitivity of the combined identification was 78.93% and the specificity was 80.39%. The levels of serum IL-6 and CRP were positively correlated with the severity of the COVID-19(P<0.05). Conclusion The serum levels of IL-6 and CRP are abnormally high in patients with severe COVID-19,and positively correlated with the severity of COVID-19,which is helpful to distinguish the severity of COVID-19.

关 键 词：新冠肺炎 炎症标志物 白细胞介素-6 淀粉样蛋白A 降钙素原 C反应蛋白 

分 类 号：R183.3[医药卫生—流行病学]