重症肺炎患者外周血炎症因子水平及其预后预测价值  

Peripheral blood inflammatory factors of patients with severe pneumonia and their values in prediction of prognosis

作　　者：郭佳林 郭家颖 杨记康 张巧梅[1] 张利梅[1] 赵童[1] GUO Jia-lin;GUO Jia-ying;YANG Ji-kang;ZHANG Qiao-mei;ZHANG Li-mei;ZHAO Tong(Jiaozuo People′s Hospital,Jiaozuo,Henan 454000,China)

机构地区：[1]焦作市人民医院感染性疾病科,河南焦作454000

出　　处：《中华医院感染学杂志》2022年第20期3057-3061,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划联合共建基金项目(LHGJ20191344)。

摘　　要：目的探讨重症肺炎患者外周血白细胞介素-6(IL-6)、IL-8、干扰素-γ(IFN-γ)、IL-1β、IL-4及其预测价值与预后。方法选取2018年3月-2021年3月焦作市人民医院收治的64例重症肺炎患者(重症感染组)和101例普通肺炎患者(普通感染组),比较两组患者临床资料,根据预后情况将重症感染组分为预后良好组(46例)和预后不良组(18例),采用酶联免疫法检测外周血IL-6、IL-8、IFN-γ、IL-1β及IL-4水平并使用受试者工作特征(ROC)曲线分析其对预后不良的评估价值。结果重症感染组患者的急性生理与慢性健康Ⅱ(APACHEⅡ)评分、肺炎严重指数(PSI)评分均高于普通感染组(P<0.05),重症感染组患者外周血IL-6、IL-8、IFN-γ、IL-1β和IL-4高于普通感染组(P<0.05);IL-6、IL-8、IFN-γ、IL-1β和IL-4预测重症肺炎的曲线下面积(AUC)分别为0.839、0.827、0.842、0.813、0.790(P<0.05)。在重症感染组患者中,预后不良组患者外周血IL-6、IL-8、IFN-γ、IL-1β和IL-4高于预后良好组(P<0.05),IL-6、IL-8、IFN-γ、IL-1β和IL-4水平对不良预后AUC分别为0.757、0.686、0.728、0.766、0.780(P<0.05)。结论外周血IL-6、IL-8、IFN-γ、IL-1β和IL-4在重症肺炎患者体内水平升高,对重症肺炎及其不良预后分别表现出良好的鉴别价值和预测价值。OBJECTIVE To explore levels of peripheral blood interleukin-6(IL-6),IL-8,interferon-γ(IFN-γ),IL-1βand IL-4 and their predictive value and and prognosis in patients with severe pneumonia.METHODS From Mar.2018 to Mar.2021,64 patients with severe pneumonia(severe infection group)and 101 patients with common pneumonia(common infection group)admitted to Jiaozuo People′s Hospital were selected,and the clinical data were compared between the two groups.According to different prognosis,patients in severe infection group were divided into a good prognosis group(46 cases)and a poor prognosis group(18 cases).The levels of peripheral blood IL-6,IL-8,IFN-γ,IL-1βand IL-4 were detected by enzyme linked immunosorbent assay,and the receiver operating characteristic(ROC)curves was used to analyzed their evaluation value of poor prognosis.RESULTS The scores of Acute Physiology and Chronic Health Evaluation II(APACHEⅡ)and pneumonia severity index(PSI)in severe infection group were higher than those in common infection group(P<0.05),and levels of peripheral blood IL-6,IL-8,IFN-γ,IL-1βand IL-4 were higher than those in common infection group(P<0.05).The area under the curve(AUC)of IL-6,IL-8,IFN-γ,IL-1βand IL-4 levels in predicting severe pneumonia were 0.839,0.827,0.842,0.813 and 0.790,respectively(P<0.05).In the severe infection group,the levels of peripheral blood IL-6,IL-8,IFN-γ,IL-1βand IL-4 in poor prognosis group were higher than those in good prognosis group(P<0.05).AUC of IL-6,IL-8,IFN-γ,IL-1βand IL-4 for predicting poor prognosis were 0.757,0.686,0.728,0.766 and 0.780,respectively(P<0.05).CONCLUSION The levels of peripheral blood IL-6,IL-8,IFN-γ,IL-1βand IL-4 were elevated in patients with severe pneumonia,which had good differential and predictive value for severe pneumonia and its poor prognosis,respectively.

关 键 词：重症肺炎 炎症因子 干扰素-Γ 预后 预测价值 

分 类 号：R563.1[医药卫生—呼吸系统]