高龄奥密克戎变异株感染者血清白细胞介素6的临床意义及与合并基础疾病的相关性  

Clinical significance of serum interleukin 6 in elderly patients infected with severe acute respiratory syndrome coronavirus 2 omicron variant and its correlation with underlying diseases

作　　者：董旭 徐爱静 葛玲玲 陈怡[1] 杨明 薛建亚 DONG Xu;XU Ai-jing;GE Ling-ling;CHEN Yi;YANG Ming;XUE Jian-ya(Department of Infectious Diseases,The First Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200433,China;Internal Medicine Training Base,The First Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]海军军医大学(第二军医大学)第一附属医院感染科,上海200433 [2]海军军医大学(第二军医大学)第一附属医院内科规培基地,上海200433

出　　处：《海军军医大学学报》2022年第9期1037-1043,共7页Academic Journal of Naval Medical University

摘　　要：目的探究血清IL-6在高龄奥密克戎变异株感染者中的临床意义,以及合并基础疾病与血清IL-6水平的相关性。方法纳入2022年4-6月入住海军军医大学(第二军医大学)第一附属医院感染科、严重急性呼吸综合征冠状病毒2 RNA检测呈阳性的高龄(>80岁)奥密克戎变异株感染患者22例,采用流式细胞学检测法测定血清IL-6水平,采用免疫比浊法测定CRP水平。根据影像学检查有无肺炎表现将患者分为肺炎组(16例)和无肺炎组(6例),根据病情分为重症组(重型和危重型,5例)和非重症组(轻型和普通型,17例),采用二分类logistic回归模型和ROC曲线分析血清IL-6、CRP水平与病情严重程度和是否进展为肺炎的相关性,同时探究合并基础疾病与血清IL-6水平的关系。结果22例患者中轻型6例、普通型11例、重型3例、危重型2例。肺炎组基线血清IL-6水平高于无肺炎组[(20.16±12.36)pg/mL vs(5.42±1.57)pg/mL,P=0.009],肺炎组和无肺炎组基线血清CRP水平差异无统计学意义(P>0.05);重症组和非重症组基线血清IL-6和CRP水平差异均无统计学意义(P均>0.05)。logistic回归分析显示,基线血清IL-6、CRP水平可能与感染奥密克戎变异株后进展为肺炎有关,但均无统计学意义(OR=2.407,95%CI 0.915~6.328;OR=1.030,95%CI 0.952~1.114);ROC曲线分析显示,基线血清IL-6、CRP预测患者进展为肺炎的AUC值分别为0.969(95%CI 0.900~1.000)、0.656(95%CI 0.380~0.932),两者AUC值差异有统计学意义(Z=2.154,P=0.030)。有无高血压病、糖尿病、冠心病、慢性肾脏病、慢性阻塞性肺疾病的患者基线血清IL-6水平、重症患者占比、肺炎患者占比差异均无统计学意义(P均>0.05)。合并1种、2种、3种及以上基础疾病的高龄奥密克戎变异株感染者基线血清IL-6水平分别为12.50(9.15,21.75)、23.55(9.63,50.10)、10.90(5.20,18.88)pg/mL,差异无统计学意义(P>0.05)。结论在奥密克戎变异株感染患者中,有肺炎表现者血�Objective To investigate the clinical significance of serum interleukin 6(IL-6)in elderly patients infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)omicron variant and its correlation with underlying diseases.Methods A total of 22 elderly patients(>80 years old)infected with omicron variant,who were admitted to Department of Infectious Diseases,The First Affiliated Hospital of Naval Medical University(Second Military Medical University)from Apr.to Jun.2022 and tested positive for SARS-CoV-2 RNA,were included.The level of serum IL-6was measured by flow cytometry,and the level of serum C reactive protein(CRP)was measured by immunonephelometry.Patients were divided into pneumonia group(16 cases)and non-pneumonia group(6 cases)according to the imaging examination results,and were divided into severe group(severe and critical type,5 cases)and non-severe group(mild and normal type,17 cases)according to the condition.Binary logistic regression model and receiver operating characteristic(ROC)curve were used to analyze the correlation between serum IL-6 and CRP levels and the severity of the disease and whether it would progress to pneumonia.Meanwhile,the relationships between underlying diseases and serum IL-6 level were explored.Results Among the 22 patients,6 were mild,11 were normal,3 were severe,and 2 were critical.The baseline serum IL-6level in the pneumonia group was significantly higher than that in the non-pneumonia group([20.16±12.36]pg/mL vs[5.42±1.57]pg/mL,P=0.009),and there was no significant difference in baseline serum CRP level between the 2 groups(P>0.05).There were no significant differences in baseline serum IL-6 or CRP levels between the severe group and the nonsevere group(both P>0.05).Logistic regression analysis showed that the baseline serum IL-6 and CRP might be related to pneumonia after infection with omicron variant(odds ratio[OR]=2.407,95%confidence interval[CI]0.915-6.328;OR=1.030,95%CI 0.952-1.114).ROC curve analysis showed that the area under curve values of serum

关 键 词：80岁以上老年人 新型冠状病毒肺炎 奥密克戎变异株 严重急性呼吸综合征冠状病毒2 白细胞介素6 基础疾病 

分 类 号：R511[医药卫生—内科学]