老年新型冠状病毒肺炎患者血清IL-2R、IL-6、TNF-α水平变化及临床意义  

Changes and clinical significance of serum IL-2R,IL-6 and TNF-α in elderly patients with COVID-19

作　　者：邹青旭 林风武[1] 王岩[1] 辛华[1] 谭娟[2] 张乐宁[1] 许雷[1] 许哲男[1] ZOU Qingxu;LIN Fengwu;WANG Yan;XN Hua;TAN Juan;ZHANG Lening;XU Lei;XU Zhenan(China-Japan Union Hospital of Jilin University,Changchun 130033,China;Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430100,China)

机构地区：[1]吉林大学中日联谊医院,长春130033 [2]华中科技大学同济医学院附属同济医院,武汉430100

出　　处：《长春中医药大学学报》2020年第4期692-694,共3页Journal of Changchun University of Chinese Medicine

摘　　要：目的探讨IL-2R、IL-6、TNF-α等炎性细胞因子在老年新型冠状病毒肺炎患者病情进展中的作用及临床意义。方法选取50例进展期新冠肺炎患者病例进行研究。将患者按照《新型冠状病毒肺炎诊疗方案(试行第六版)》分为普通型、重症型及危重型,在病程进展期测定静脉血中的炎性细胞因子,研究对比各型中IL-2R、IL-6、TNF-α的含量;危重型在病程恢复期复查细胞因子再次进行评估。结果各型患者年龄及基础疾病分布有明显结构性差异,年龄和和基础疾病与肺炎分级程度呈正相关;普通型和重症型之间IL-2R、IL-6及TNF-α无明显统计学意义,2者IL-2R、IL-6及TNF-α水平处于正常或略高于参考值,但危重型与普通型、重症型之间存在显著统计学差异(P<0.01);危重型在恢复期IL-2R、IL-6显著下降。结论 IL-2R、IL-6、TNF-α在老年新冠肺炎患者,尤其在危重型患者的发病机制中可能起重要作用,可作为评估病情和协助诊疗的辅助性检验指标。Objective To investigate the role and clinical significance of inflammatory cytokines of IL-2R,IL-6 and TNF-α in elderly patients with COVID-19.Methods A total of 50 patients with COVID-19 were selected and divided into three groups:general group,severe group and critical group according to Guidelines on the Novel Coronavirus-Infected Pneumonia Diagnosis and Treatment (Trial Sixth Edition).The IL-2R,IL-6,and TNF-α levels of different groups were tested through venous blood in progression period.The cytokines in the critical group were reexamined in the recovery period for further assessment.Results There were significant structural differences among the three groups of patients in terms of age and underlying medical conditions,which positively correlated with the severity of pneumonia.There were no statistically significant differences in IL-2R,IL-6 and TNF-α between the general group and the severe group,and the IL-2R,IL-6 and TNF-α values in the general group and the severe group were normal or slightly higher than the reference values,but there was a significant statistical difference between the critical group and the general group,the critical group and the severe group (P<0.01).In recovery period,IL-2R and IL-6 decreased significantly in the critical group.Conclusion Inflammatory cytokines play an important mediating role in the progression of elderly patients with COVID-19,especially in the critical group,and can be used as a reliable index to assess the condition and assist diagnosis and treatment.

关 键 词：新型冠状病毒肺炎 炎性细胞因子 老年患者 炎症风暴 

分 类 号：R446[医药卫生—诊断学]