血清IL-17和CHE及和肽素水平与老年COPD合并肺部感染的相关性  

Correlation between serum IL-17,CHE and copeptin and pulmonary infection in elderly patients with COPD

作　　者：胡诗礼 李丽华[2] 张李 李云飞 吾曼莉 HU Shi-li;LI Li-hua;ZHANG Li;LI Yun-fei;WU Man-li(The Third Affiliated Hospital of Zunyi Medical University(The First Peoples Hospital of Zunyi City),Zunyi,Guizhou 563000,China;不详)

机构地区：[1]遵义医科大学第三附属医院(遵义市第一人民医院)呼吸内科,贵州遵义563000 [2]贵州航天医院肾内科,贵州遵义563003

出　　处：《中华医院感染学杂志》2020年第21期3272-3276,共5页Chinese Journal of Nosocomiology

基　　金：贵州省科学技术基金资助项目[黔科合LH字(2014)7569号]。

摘　　要：目的探讨血清白细胞介素-17(IL-17)、胆碱酯酶(CHE)、和肽素水平与老年慢性阻塞性肺疾病(COPD)合并肺部感染患者感染程度及预后的相关性。方法选取2016年3月-2019年3月遵义市第一人民医院257例老年COPD患者作为研究对象,根据患者是否合并肺部感染分为感染组(n=112)与未感染组(n=145)。比较两组及感染组不同感染程度、不同预后患者血清IL-17、CHE、和肽素水平,分析血清各指标与常规感染标志物[降钙素原(PCT)、C-反应蛋白(CRP)]及感染程度相关性,并探讨血清指标对预后的预测价值。结果感染组血清IL-17、和肽素水平与血清PCT、CRP水平、感染程度呈正相关,CHE与血清PCT、CRP水平、感染程度呈负相关(P<0.05);感染组存活患者血清IL-17、和肽素水平低于病死患者,CHE水平高于病死患者(P<0.05);血清IL-17、CHE、和肽素联合预测老年COPD伴肺部感染预后的曲线下面积为0.851,敏感度为95.00%,特异度为66.30%。结论血清IL-17、和肽素、CHE水平与老年COPD伴肺部感染存在一定相关性,三者联合具有成为老年COPD伴肺部感染患者预后有效预测手段的潜力,可为临床对症治疗提供新靶点。OBJECTIVE To explore the correlation between the levels of serum interleukin-17(IL-17),cholinesterase(CHE),and copeptin and the severity of infection and prognosis of the elderly patients complicated with pulmonary infection.METHODS A total of 257 elderly patients with COPD who were treated in the First People’s Hospital of Zunyi City from Mar 2016 to Mar 2019 were recruited as the study objects and were divided into the infection group with 112 cases and the non-infection group with 145 cases according to the status of pulmonary infection.The levels of serum IL-17,CHE and copeptin were compared between the two groups and among the patients with different degree of infection.The correlation between the serological indexes and the routine infection markers procalcitonin(PCT),C-reactive protein(CRP)as well as the degree of infection was observed,and the value of the serological indexes in prediction of prognosis was explored.RESULTS The levels of serum IL-17 and copeptin were positively correlated with the serum PCT level,CRP level and degree of infection,the CHE was negatively correlated with the serum PCT level,CRP level and the degree of infection(P<0.05).In the infection group,the levels of serum IL-17 and copeptin of the patients who survived were significantly lower than those of the patients who died,while the CHE level of the patients who survived was significantly higher than that of the patients who died(P<0.05).The area under curve of the joint detection of serum IL-17,CHE and copeptin was 0.851 in prediction of the prognosis of the elderly COPD patients complicated with pulmonary infection,the sensitivity 95.00%,the specificity 66.30%.CONCLUSION There is certain correlation between the levels of serum IL-17,copeptin and CHE and the pulmonary infection in the elderly patients with COPD.The joint detection of the three indexes can effectively predict the prognosis of the elderly COPD patients complicated with pulmonary infection,which can provide new targets for clinical symptomatic treatment.

关 键 词：白细胞介素-17 胆碱酯酶 和肽素 慢性阻塞性肺疾病 肺部感染 感染程度 

分 类 号：R563[医药卫生—呼吸系统]