肺泡灌洗液TLR4、IGF-1、IL-10对老年重症肺部感染患者生存状况的预测价值  

Value of TLR4,IGF-1 and IL-10 in serum and alveolar lavage fluid in predict survival status in elderly patients with severe pulmonary infection

作　　者：张学峰 张君 李丰环 ZHANG Xue-feng;ZHANG Jun;LI Feng-huan(Yantai Mountain Hospital,Yantai,Shandong 264000,China)

机构地区：[1]烟台市烟台山医院呼吸与危重症医学科,山东烟台264000

出　　处：《中华医院感染学杂志》2023年第15期2281-2284,共4页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划项目(2019WS19921)。

摘　　要：目的 探究肺泡灌洗液Toll样受体4(TLR4)、胰岛素样生长因子1(IGF-1)、白细胞介素-10(IL-10)对老年重症肺部感染患者生存状况预测应用价值。方法 回顾性选取烟台市烟台山医院2020年1月-2022年10月收治的老年重症肺部感染患者105例为研究对象,根据30 d生存状况分为生存组(69例)、死亡组(36例)。比较两组入院第1天、1周后血清、肺泡灌洗液TLR4、IGF-1、IL-10水平,采用受试者工作特征(ROC)曲线分析血清与肺泡灌洗液各指标对生存状况的预测价值,KM曲线进行生存分析。结果 入院1周后死亡组血清及肺泡灌洗液TLR4、IL-10高于生存组,IGF-1低于生存组(P<0.05);血清及肺泡灌洗液TLR4、IGF-1、IL-10联合预测曲线下面积(AUC)大于血清及肺泡灌洗液IGF-1、IL-10、TLR4单独预测的AUC;KM曲线分析,血清、肺泡灌洗液TLR4、IL-10低表达者生存率高于高表达者,IGF-1低表达者生存率低于高表达者(P<0.05)。结论 老年重症肺部感染患者血清与肺泡灌洗液TLR4、IGF-1、IL-10表达水平与生存状况密切相关,联合检测可提高预后预测价值,为病情监测、疗效判断提供依据。OBJECTIVE To investigate the application value of Toll-like receptor 4(TLR4),insulin-like growth factor 1(IGF-1),and interleukin-10(IL-10)to predict survival status in serum and alveolar lavage fluid of elderly patients with severe pulmonary infection.METHODS From Jan 2020 to Oct 2022,105 elderly patients with severe lung infection admitted to Yantai Mountain Hospital in Yantai City were retrospectively analyzed.According to the 30-day survival status,they were divided into the survival group(69 cases)and death group(36 cases).The TLR4,IGF-1 and IL-10 levels in serum and alveolar lavage fluid were compared between the two groups on the first day and one week after admission.The predictive value of above indexes in survival status was analyzed by receiver operating characteristic(ROC)curves,and KM curve was used for survival analysis.RESULTS One week after admission,the serum and alveolar lavage fluid TLR4 and IL-1o levels in the death group were higher than those in the survival group,while IGF-1 was lower than that in the survival group(P<0.05).The area under the curve(AUC)of the combination detection of serum and alveolar lavage fluid TLR4,IGF-1,and IL-1o levels was larger than that of the individual detection.KM curve analysis showed that the survival rate of patients with low TLR4 and IL-1o expression in serum and alveolar lavage fluid was higher than that with high expression,and the survival rate of patients with low IGF-1 expression was lower than that of high expression(P<0.05).CONCLUSION The serum levels of TLR4,IGF-1,and IL-10 in alveolar lavage fluid are closely related to survival status in elderly patients with severe pulmonary infection.Combined detection can improve the prognostic value and provide a basis for disease monitoring and efficacy evaluation.

关 键 词：重症肺部感染 肺泡灌洗液 Toll样受体4 胰岛素样生长因子1 白细胞介素-10 生存状况 

分 类 号：R563.1[医药卫生—呼吸系统]