血清白细胞介素-10、白细胞介素-17、白细胞介素-23检测对慢性阻塞性肺疾病合并侵袭性肺曲霉菌感染的诊断及预后评估价值  

Value of serum IL-10,IL-17 and IL-23 in the diagnosis and prognosis evaluation of COPD complicated with invasive pulmonary Aspergillus infection

作　　者：胡传玺[1] 刘灵燕[1] 李漫[1] HU Chuanxi;LIU Lingyan;LI Man(Department of Clinical Laboratory,the Ninth People’s Hospital Affiliated to School of Medicine of Shanghai Jiaotong University,Shanghai 201999,China)

机构地区：[1]上海交通大学医学院附属第九人民医院检验科,上海201999

出　　处：《陕西医学杂志》2023年第10期1415-1418,共4页Shaanxi Medical Journal

基　　金：上海市科学技术计划项目(174119678)。

摘　　要：目的:探讨血清白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、白细胞介素-23(IL-23)对慢性阻塞性肺疾病(COPD)合并侵袭性肺曲霉菌(IPA)感染的诊断及预后评估价值。方法:选取90例COPD急性加重住院患者,筛查患者IPA感染情况,41例合并IPA感染的患者作为感染组,余49例作为无感染组,比较两组血清IL-10、IL-17、IL-23水平,分析其对IPA感染的诊断价值;并统计感染组死亡情况,分析血清IL-10、IL-17、IL-23水平与预后的关系。结果:感染组IL-10水平低于无感染组(P<0.05),IL-17、IL-23水平高于无感染组(均P<0.05);血清IL-10、IL-17、IL-23及IL-10和IL-17联合、IL-10和IL-23联合、三项指标联合诊断COPD合并IPA感染ROC曲线下面积(AUC)分别为0.692、0.685、0.762、0.836、0.884、0.893,敏感度、特异度分别为66.45%、45.24%,70.50%、52.60%,78.05%、71.43%,60.98%、93.88%,87.80%、77.55%,90.24%、83.50%。41例COPD合并IPA感染患者中,6例死亡,死亡者血清IL-10明显低于存活者,血清IL-17、IL-23水平显著高于存活者(均P<0.05),但Cox回归分析显示仅IL-17为影响患者预后的独立因素(P<0.05)。结论:对于COPD急性加重住院患者,合并IPA感染血清IL-10较低,IL-17、IL-23较高,其联合检测对于IPA感染的诊断及患者预后评估临床价值较高。Objective:To investigate the value of serum interleukin(IL)-10,IL-17 and IL-23 in the diagnosis and prognosis evaluation of chronic obstructive pulmonary disease(COPD)with invasive pulmonary aspergillus(IPA)infection.Methods:Ninety hospitalized patients with acute exacerbation of COPD were selected.According to the status of IPA infection,the subjects were divided into infection group(41 patients with IPA infection)and non-infection group(the other 49 patients).Serum IL-10,IL-17 and IL-23 levels were compared between the two groups,and their diagnostic value for IPA infection was analyzed.The mortality of infection group was calculated,and the relationship between serum IL-10,IL-17 and IL-23 levels and the prognosis was analyzed.Results:Compared with the non-infection group,IL-10 level was lower,IL-17 and IL-23 levels were higher in the infection group(all P<0.05).The area under the ROC curve(AUC)values of serum IL-10,IL-17,IL-23,IL-10 combined with IL-17,IL-10 combined with IL-23,and combination of the three to diagnose COPD combined with IPA infection were 0.692,0.685,0.762,0.836,0.884 and 0.893,respectively.The sensitivity and specificity were 66.45% and 45.24%,70.50% and 52.60%,78.05% and 71.43%,60.98% and 93.88%,87.80% and 77.55%,90.24% and 83.50%,respectively.Among the 41 patients with COPD complicated with IPA infection,6 patients died.The dead had significantly lower serum IL-10 level and significantly higher serum IL-17 and IL-23 levels than the survivors(all P<0.05).However,Cox regression analysis showed that only IL-17 was an independent factor affecting the prognosis of patients(P<0.05).Conclusion:For patients with acute exacerbation of COPD,serum IL-10 level is lower,and IL-17 and IL-23 levels are higher in patients with IPA infection.Joint detection of these indicators can help to diagnose IPA infection and evaluate the prognosis.

关 键 词：慢性阻塞性肺疾病 白细胞介素-10 白细胞介素-17 白细胞介素-23 诊断 预后 

分 类 号：R563.9[医药卫生—呼吸系统]