IFN-γ、TNF-α、IL-6及SAA在新型冠状病毒肺炎患者中的水平变化及临床意义  

The level changes and clinical significance of IFN-γ,TNF-α,IL-6 and SAA in patients with Corona Virus Disease 2019

作　　者：庞科[1] 黄澄澄 高红丽[2] 邹凡文[1] 李杰[3] 龙晓莉[1] PANG Ke;HUANG Chengcheng;GAO Hongli;ZOU Fanwen;LI Jie;LONG Xiaoli(Department of Geriatrics,Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China;Department of Ultrasonography,Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China;Department of Nephrology and Rheumatology,Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院老年病科,重庆402160 [2]重庆医科大学附属永川医院超声科,重庆402160 [3]重庆医科大学附属永川医院肾病风湿科,重庆402160

出　　处：《检验医学与临床》2021年第6期721-724,共4页Laboratory Medicine and Clinic

基　　金：重庆市永川区科技局新型冠状病毒肺炎应急项目(ycstc.2020nb0215)。

摘　　要：目的探讨干扰素γ(IFN-γ)、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、血清淀粉样蛋白A(SAA)在新型冠状病毒肺炎(COVID-19)患者中的水平变化及临床意义。方法选取2020年1月22日至3月20日该院隔离病房收治的81例COVID-19患者为研究对象,其中普通型50例(普通组),重型31例(重型组)。选取同期在该院就诊的流行性感冒(简称流感)患者32例为普通流感组。比较3组患者入院时IFN-γ、TNF-α、IL-6及SAA水平。分析普通组与重型组患者上述指标水平的动态变化。采用受试者工作特征曲线(ROC曲线)分析SAA在诊断COVID-19中的价值。结果重型组入院时IFN-γ、TNF-α、IL-6及SAA水平明显高于普通组及普通流感组入院时,差异有统计学意义(P<0.05)。普通组入院时IFN-γ、TNF-α、IL-6水平与普通流感组入院时对比,差异无统计学意义(P>0.05)。普通组入院时SAA水平与普通流感组入院时对比,差异有统计学意义(P<0.05)。普通组入院后第3、7、10天IFN-γ、TNF-α、IL-6及SAA水平高于入院时,差异有统计学意义(P<0.05);入院后第3、7天IFN-γ、TNF-α、IL-6及SAA水平高于入院后第10天,差异有统计学意义(P<0.05)。重型组入院后第3、7天IFN-γ、TNF-α、IL-6及SAA水平高于入院时和入院后第10天,差异有统计学意义(P<0.05);入院后第10天IFN-γ、TNF-α、IL-6及SAA水平低于入院时,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,SAA诊断COVID-19的曲线下面积为0.925,其灵敏度和特异度分别为88.2%和84.4%,最佳临界值为17.0 mg/L。结论监测IFN-γ、TNF-α、IL-6水平变化可为COVID-19病情评估提供依据,SAA水平可用于COVID-19的辅助诊断。Objective To analyze the level changes and clinical significance of interferonγ(IFN-γ),tumor necrosis factorα(TNF-α),interleukin(IL)-6 and serum amyloid A(SAA)in patients with Corona Virus Disease 2019(COVID-19).Methods A total of 81 patients with COVID-19 were selected as research subjects in the hospital from 22 January to 20 March,2020.Among them,50 cases were common type(COVID-19 common group)and 31 cases were severe type(COVID-19 severe group).And 32 cases with influenza were selected as common influenza group.The peripheral blood levels of IFN-γ,TNF-α,IL-6 and SAA in three groups on admission were compared.The dynamic changes of these four indicators in COVID-19 common group and COVID-19 severe group were analyzed.Receiver operating characteristic curve(ROC curve)was used to analyze the value of SAA in the diagnosis of COVID-19.Results The levels of IFN-γ,TNF-α,IL-6 and SAA in COVID-19 severe group were higher than those in common influenza group and COVID-19 common group on admission(P<0.05).And the differences of the levels of IFN-γ,TNF-αand IL-6 in COVID-19 common group and common influenza group on admission had no statistical significance(P>0.05).Meanwhile,the level of SAA between COVID-19 common group and common influenza group on admission had statistical significance(P<0.05).The levels of IFN-γ,TNF-α,IL-6 and SAA in COVID-19 common group on the 3rd,7th and 10th day after admission were significantly higher than those on admission(P<0.05).The levels of IFN-γ,TNF-α,IL-6 and SAA in COVID-19 common group on the 3rd,7th day after admission were significantly higher than those on the 10th day after admission(P<0.05).The levels of IFN-γ,TNF-α,IL-6 and SAA on the 3rd and 7th days after admission in COVID-19 severe group were higher than those on admission and the 10th day after admission(P<0.05).And the levels of IFN-γ,TNF-α,IL-6 and SAA in COVID-19 severe group on the 10th day after admission were significantly lower than those on admission(P<0.05).ROC curve analysis showed that area unde

关 键 词：新型冠状病毒肺炎 干扰素Γ 肿瘤坏死因子α 血清淀粉样蛋白A 白细胞介素6 

分 类 号：R563[医药卫生—呼吸系统]