血清白细胞介素-6、白细胞介素-8、血管生成素-2水平对老年重症肺炎患者预后的评估价值  

The prognostic value of serum IL-6,IL-8 and ANG-2 levels in elderly patients with severe pneumonia

作　　者：贺永梅[1] 张娅惠 张依[2] HE Yong-Mei;ZHANG Ya-Hui;ZHANG Yi(Department of Health Management,Aerospace Center Hospital,Beijing 100049,China;Department of Gereology,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院健康管理部,北京100049 [2]航天中心医院老年医学二科,北京100049

出　　处：《中国临床医生杂志》2023年第12期1413-1417,共5页Chinese Journal For Clinicians

摘　　要：目的 探索血清白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)、血管生成素-2(angiopoietin-2,Ang-2)在老年重症肺炎患者中的表达及其对预后的评估价值。方法 选取2020年1月至2021年6月航天中心医院收治的112例老年重症肺炎患者作为研究对象,根据确诊后第28天生存情况将患者分为生存组(63例)和死亡组(49例)。同时选取同期航天中心医院无感染健康体检者40例作为健康对照组。检测入组患者的C反应蛋白(C-reactive protein,CRP)、白细胞(white blood cell,WBC)、降钙素原(procalcitonin,PCT)、血清IL-6、IL-8、Ang-2水平,同时记录重症肺炎患者的急性生理学与慢性健康状况评分Ⅱ(acute physiology and chronic health status scoreⅡ,APACHEⅡ)。Pearson法分析Ang-2与各感染指标的相关性;多因素logistic回归分析影响因素;绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),分析PCT、APACHEⅡ、IL-8、Ang-2对老年重症肺炎患者临床转归的评估价值。结果 112例老年重症肺炎患者中63例(56.25%)经治疗后好转并转出监护室,49例(43.75%)病情恶化死亡;生存组的PCT、APACHEⅡ评分、IL-6、IL-8、Ang-2明显低于死亡组(P<0.001);老年重症肺炎患者Ang-2与IL-6、IL-8、PCT及APACHEⅡ均呈正相关(r=0.284,P=0.002;r=0.423,P<0.001;r=0.189,P=0.046;r=0.256,P=0.006)。多因素logistic回归分析显示,血清IL-8(OR=1.198,95%CI 1.078~1.333)、血清Ang-2(OR=1.949,95%CI 1.346~2.824)、PCT(OR=1.376,95%CI 1.003~1.888)、APACHEⅡ评分(OR=1.462,95%CI1.042~2.051)是死亡的危险因素(P<0.05)。ROC曲线结果显示,血清IL-8、Ang-2、PCT和APACHEⅡ的ROC曲线下面积分别是0.837、0.879、0.694、0.697,其中Ang-2对老年重症肺炎患者住院期间死亡预测AUC为0.879,灵敏度93.9%,特异度68.3%,对老年重症肺炎患者的死亡预测评估价值最高。结论 血清IL-6、IL-8、Ang-2可作为老年重症肺炎疾病严重程度评价指标,IL-8、Ang-2对老�Objective To explore the expression of serum interleukin-6(IL-6),interleukin-8(IL-8)and ang-2(ANG-2)in elderly patients with severe pneumonia and their prognostic value.Method 112 elderly patients with severe pneumonia were admitted,from January 2020 to June 2021,and the prognosis of the enrolled patients was recorded.According to the survival on the 28th day after diagnosis,they were divided into survival group(63 cases)and death group(49 cases).At the same time,40 healthy subjects were selected as healthy control group.The levels of C-reactive protein(CRP),white blood cell(WBC),procalcitonin(PCT),serum IL-6,IL-8 and Ang-2 were detected,and the acute physiology and chronic health status scoreⅡ(APACHEⅡ)of patients with severe pneumonia were recorded.The correlation between Ang-2 and infection indexes was analyzed by Pearson method.Multivariate logistic regression analysis of influencing factors;The receiver operating characteristic curve(ROC)was drawn to analyze the evaluation value of PCT,APACHEⅡ,IL-8 and Ang-2 of elderly patients with severe pneumonia.Result Among 112 elderly patients,63 cases(56.25%)were transferred out of ICU,49 cases(43.75%)deteriorated and died.PCT,APACHEⅡ,IL-6,IL-8,Ang-2 in survival group were significantly lower than those in death group(P<0.001);Ang-2 was positively correlated with IL-6,IL-8,PCT and APACHEⅡin elderly patients with severe pneumonia(r=0.284,P=0.002;r=0.423,P<0.001;r=0.189,P=0.046;r=0.256,P=0.006).Logistic regression analysis showed that serum IL-8(OR=1.198,95%CI 1.078~1.333),serum Ang-2(OR=1.949,95%CI 1.346~2.824),PCT(OR=1.376,95%CI 1.003~1.888),APACHEⅡscore(OR=1.462,95%CI 1.042~2.051)were risk factors for death(P<0.05).The ROC curve results showed that the areas under ROC curve of serum IL-8,Ang-2 and PCT,APACHEⅡwere 0.837,0.879 and 0.694,0.697,respectively.The AUC of Ang-2 for predicting death in elderly patients with severe pneumonia during hospitalization was 0.879,and the sensitivity was 93.9%,the specificity was 68.3%.And the evaluation value of death p

关 键 词：老年 重症肺炎 降钙素原 白细胞介素-6 白细胞介素-8 血管生成素-2 

分 类 号：R[医药卫生]