血清相关炎性因子水平、氧化应激反应指标与重症肺炎患者CPIS评分的相关性研究  

Correlation between serum levels of inflammatory cytokines,oxidative stress response indicators and clinical pulmonary infection score in patients with severe pneumonia

作　　者：陈高瑛 王红燕[1] 燕肖晗 苏醒 齐红松 CHEN Gao-ying;WANG Hong-yan;YAN Xiao-han(SU Xing,QI Hong-song.Department of Respiratory and Critical Care Medicine,First Affiliated Hospital of Henan University,Kaifeng 475000,Henan,CHINA)

机构地区：[1]河南大学第一附属医院呼吸与危重症医学科,河南开封475000

出　　处：《海南医学》2023年第18期2585-2589,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20220648)。

摘　　要：目的探讨血清相关炎性因子水平、氧化应激反应指标与重症肺炎患者临床肺部感染评分(CPIS)的相关性。方法选取2020年2月至2023年1月河南大学第一附属医院呼吸与危重症医学科收治的178例重症肺炎患者作为重症肺炎组,同期178例普通肺炎患者作为普通肺炎组,根据治疗28 d后的预后情况将重症肺炎患者分为死亡组59例和生存组119例。比较重症肺炎组和普通肺炎组(入院时)的血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、超氧化物歧化酶(SOD)、丙二醛(MDA)、过氧化脂质(LPO)水平及CPIS评分;比较死亡组和生存组患者(入院时、入院3 d、7 d后)的血清IL-6、TNF-α、CRP、SOD、MDA、LPO水平;采用Pearson相关法分析血清IL-6、TNF-α、CRP、SOD、MDA、LPO水平与PCIS评分的相关性,采用多因素Logistic回归法分析患者死亡的影响因素,采用受试者工作特征曲线(ROC)分析血清IL-6、TNF-α、CRP、SOD、MDA、LPO水平联合检测对重症肺炎患者死亡的预测价值。结果重症肺炎组患者入院时的血清IL-6、TNF-α、CRP、MDA、LPO水平及CPIS评分明显高于普通肺炎组,SOD水平明显低于普通肺炎组,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,CPIS评分与入院时血清IL-6、TNF-α、CRP、MDA、LPO水平呈正相关(P<0.05),与SOD水平呈负相关(P<0.05);死亡组患者入院3 d、7 d后的血清IL-6、TNF-α、CRP、MDA、LPO水平均高于生存组,SOD水平低于生存组,差异均有统计学意义(P<0.05);经多因素Logistic回归分析结果显示,入院3 d后血清IL-6(>64.02 ng/L)、TNF-α(>62.38 ng/L)、CRP(>43.62 mg/L)、MDA(>7.20 mmol/L)、LPO(>20.10μmol/L)水平与入院7 d后血清IL-6(>58.47 ng/L)、TNF-α(>53.58 ng/L)、CRP(>38.20 mg/L)、MDA(>5.91 mmol/L)、LPO(>20.88μmol/L)水平均是重症肺炎患者治疗28 d后死亡危险因素(P<0.05),而血清SOD水平入院3 d后(>5.48 U/mL)、7 d后(>6.49 U/mL)是保护因素(P<0.05);经RObjective To investigate the correlation between serum inflammatory factors,oxidative stress response index and clinical pulmonary infection score(CPIS)in patients with severe pneumonia.Methods A total of 178 patients with severe pneumonia admitted to the Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Henan University from February 2020 to January 2023 were selected as the severe pneumonia group,and 178 patients with common pneumonia during the same period were selected as the common pneumonia group.According to the prognosis after 28 d of treatment,the patients with severe pneumonia were classified into 59 cases of the death group and 119 cases of the survival group.Serum interleukin-6(IL-6),tumour necrosis factor-α(TNF-α),C-reactive protein(CRP),superoxide dismutase(SOD),malondialdehyde(MDA),lipid peroxide(LPO)levels,and CPIS were compared between the severe pneumonia group and the common pneumonia group(at admission),and the levels were also compared between the dead group and the survival group(at admission,3 d and 7 d after admission).Pearson analysis was used to analyze the correlation between serum IL-6,TNF-α,CRP,SOD,MDA,LPO levels and PCIS,and multifactorial logistic regression was used to analyze the influencing factors of death,and receiver operating characteristic curve(ROC)was used to analyze the predictive value of the combined test of serum IL-6,TNF-α,CRP,SOD,MDA,and LPO levels for death of patients with severe pneumonia.Results Serum levels of IL-6,TNF-α,CRP,MDA,LPO,and CPIS at admission in patients with severe pneumonia were significantly higher than those in common pneumonia group,while the level of SOD was significantly lower,with statistically significant differences(P<0.05).According to Pearson correlation analysis,the CPIS was positively correlated with serum IL-6,TNF-α,CRP,MDA,and LPO at admission(P<0.05)and negatively correlated with SOD levels(P<0.05).The serum IL-6,TNF-α,CRP,MDA,and LPO levels of the patients in death group were significantly

关 键 词：重症肺炎 临床肺部感染评分 炎性因子 氧化应激 预后 相关性 

分 类 号：R563.1[医药卫生—呼吸系统]