血清IL-4、IL-6、IL-33与老年重症肺炎患者肠道菌群的相关性分析及对预后的影响  

Correlation Analysis of Serum IL-4,IL-6,IL-33 and Intestinal Microflora in Elderly Patients with Severe Pneumonia and Their Influence on Prognosis

作　　者：冯薇[1] 赵黎 汪子凯 范小琴 宋磊[2] FENG Wei;ZHAO Li;WANG Zi-kai;FAN Xiao-qin;SONG Lei(Department of Geriatric Medicine,Clinical Medical College&Affiliated Hospital of Chengdu University,Chengdu,Sichuan,610000,China;Department of Respiratory and Critical Care Medicine,Chengdu Second People's Hospital,Chengdu,Sichuan,610000,China)

机构地区：[1]成都大学附属医院老年医学科,四川成都610000 [2]成都市第二人民医院呼吸与危重症医学科,四川成都610000

出　　处：《现代生物医学进展》2023年第13期2513-2517,共5页Progress in Modern Biomedicine

基　　金：四川省卫生和计划生育委员会科研项目(18PJ405);成都大学附属医院院级科研课题(2020YYZ31)。

摘　　要：目的:探究老年重症肺炎患者血清白介素(IL)-4、IL-6、IL-33与肠道菌群变化的相关性及预后影响因素。方法:选取我院2020年1月-2022年1月期间收治的老年重症肺炎患者中筛选82例纳入重症组,从同期老年健康体检志愿者中选取50例纳入正常组。对比两组的IL-4、IL-6、IL-33与肠道菌群水平差异,Pearson相关系数分析肠道菌群与IL-4、IL-6、IL-33水平相关性,根据重症组随访6个月的预后情况分为生存组55例、死亡组27例,对比生存组、死亡组的临床因素差异,多因素Logistic回归模型分析重症肺炎死亡的影响因素。结果:(1)对比正常组,重症组的IL-4、IL-6、IL-33水平均明显升高(P<0.05);(2)对比正常组,重症组的大肠埃希菌水平均明显升高且双歧杆菌水平明显降低(P<0.05);(3)大肠埃希菌与IL-4、IL-6、IL-33均呈正相关,双歧杆菌与IL-4、IL-6、IL-33均呈负相关;(4)对比生存组,死亡组年龄、急性生理和慢性健康(APACHE-Ⅱ)评分、IL-4、IL-6、IL-33、大肠埃希菌、机械通气比例、餐后2 h平卧比例均明显更高且双歧杆菌明显更低(P<0.05);(5)重症肺炎死亡的独立危险因素包括年龄增加、APACHE-Ⅱ评分升高、IL-4升高、IL-6升高、IL-33升高、大肠埃希菌升高、机械通气、餐后2 h平卧且独立保护因素是双歧杆菌升高。结论:老年重症肺炎患者存在明显的炎症反应与肠道菌群失衡,患者的IL-4、IL-6、IL-33、大肠埃希菌、双歧杆菌异常变化并且存在密切关系,老年重症肺炎患者的年龄、机械通气、餐后体位等因素均会影响其预后生存结局。Objective:To explore the correlation between serum interleukin(IL)-4,IL-6,IL-33 and intestinal flora in elderly patients with severe pneumonia and the influencing factors of prognosis.Methods:82 elderly patients with severe pneumonia who were admitted in our hospital from January 2020 to January 2022 were selected to be included in the severe group,and 50 elderly health volunteers from the same period were selected to be included in the normal group.The levels of IL-4,IL-6,IL-33 and intestinal flora in the two groups were compared.Pearson correlation coefficient was used to analyze the correlation between intestinal flora and the levels of IL-4,IL-6,and IL-33.According to the prognosis of the severe group at 6 months after follow-up,they were divided into survival group with 55 patients and death group with 27 patients.The differences of clinical factors between survival group and death group were compared.The influencing factors of death from severe pneumonia were analyzed by multivariate Logistic regression model.Results:(1)Compared with the normal group,the levels of IL-4,IL-6 and IL-33 in the severe group were significantly higher(P<0.05).(2)Compared with the normal group,the level of Escherichia coli in the severe group was significantly higher and the level of bifidobacterium was significantly lower(P<0.05).(3)Escherichia coli was positively correlated with IL-4,IL-6 and IL-33,while bifidobacterium was negatively correlated with IL-4,IL-6 and IL-33.(4)Compared with the survival group,the age,acute physiology and chronic health(APACHE-Ⅱ)score,IL-4,IL-6,IL-33,Escherichia coli,the proportion of mechanical ventilation,and the proportion of lying flat 2 hours after meal in the death group were significantly higher and the bifidobacterium were significantly lower(P<0.05).(5)The independent risk factors of death from severe pneumonia included increased age,increased APACHE-Ⅱscore,increased IL-4,increased IL-6,increased IL-33,increased Escherichia coli,mechanical ventilation,lying flat 2 hours after meal,and th

关 键 词：老年 重症肺炎 IL-4 IL-6 IL-33 肠道菌群 预后 相关性 

分 类 号：R563.1[医药卫生—呼吸系统] R574.62[医药卫生—内科学]