血清白细胞介素-17、降钙素原对伴肺部感染的老年重症慢性阻塞性肺疾病患者预后的预测  

Prognosis Value of Serum Interleukin-17 and Procalcitonin in Elderly Patients with Severe Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Infection

作　　者：刘自双 杜歌 陈珊珊[1] 张新峰 刘芳芳 芮曦 Liu Zishuang;Du Ge;Chen Shanshan;Zhang Xinfeng;Liu Fangfang;Rui Xi(Geriatric intensive care rehabilitation center,Beijing Rehabilitation Hospital Affiliated with Capital Medical University,Beijing 100144;Department of intensive care medicine,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730)

机构地区：[1]首都医科大学附属北京康复医院老年重症康复中心,北京100144 [2]中国医学科学院北京协和医院重症医学科,北京100730

出　　处：《国际老年医学杂志》2024年第1期18-22,共5页International Journal of Geriatrics

基　　金：首都医科大学附属北京康复医院2020-2022年科技发展专项立项任务(2020-005)。

摘　　要：目的观察血清白细胞介素(IL)-17、降钙素原(PCT)在伴肺部感染的老年重症慢性阻塞性肺疾病(COPD)患者中的表达情况,探讨其对患者预后的预测价值。方法选取2021年3月—2022年5月首都医科大学附属北京康复医院收治的120例伴肺部感染的老年重症COPD患者作为研究对象,纳入对象均进行6个月的有效随访,检测血清IL-17、PCT水平,收集一般资料,进行统计学分析。结果随访结束时,存活80例,存活率为66.67%,死亡40例,死亡率为33.33%。死亡组和存活组性别、年龄、合并各类基础疾病、吸烟史等资料比较,差异均无统计学意义(P>0.05);死亡组血清IL-17、PCT水平高于存活组,COPD病程及肺部感染病程长于存活组,差异均有统计学意义(P<0.05)。将IL-17、PCT、COPD病程、肺部感染病程作为自变量,患者的预后情况作为因变量,进行多因素logistic回归分析,得出血清IL-17、PCT水平是伴肺部感染的老年重症COPD患者死亡的独立危险因素(P<0.05)。ROC曲线显示,血清IL-17、PCT预测伴肺部感染的老年重症COPD患者死亡的曲线下面积均>0.90。结论血清IL-17、PCT水平与伴肺部感染的老年重症COPD患者预后有关,可能是死亡风险增加的危险因素。Objective To observe the expression of serum interleukin(IL)-17 and procalcitonin(PCT)in elderly patients with severe chronic obstructive pulmonary disease(COPD)accompanied by pulmonary infection,and to explore their predictive value for the prognosis of patients.Methods A total of 120 elderly patients with severe COPD complicated with pulmonary infection admitted to Beijing Rehabilitation Hospital Affiliated with Capital Medical University from March 2021 to May 2022 were selected as the study subjects.All patients were followed up for 6 months.Serum IL-17 and PCT levels were measured,general data were collected,and the above data were statistically analyzed.Results At the end of follow-up,80 patients survived with a survival rate of 66.67%and 40 patients died with a mortality rate of 33.33%.There was no significant difference in gender,age,combined underlying diseases,smoking history and other data between the death group and the survival group(P>0.05);the serum IL-17 and PCT levels in the death group were higher than those in the survival group,and the duration of COPD and pulmonary infection was longer than those in the survival group,and the differences were statistically significant(P<0.05).IL-17,PCT,duration of COPD and duration of pulmonary infection were used as independent variables,and the prognosis of patients was used as dependent variable,multivariate logistic regression analysis was performed.The results showed that serum IL-17 and PCT levels were independent risk factors for death in elderly patients with severe COPD and pulmonary infection(P<0.05).ROC curves showed that the area under the curve of serum IL-17 and PCT for predicting death in elderly patients with severe COPD and pulmonary infection was>0.90.Conclusion Serum IL-17 and PCT levels are associated with prognosis in elderly patients with severe COPD with pulmonary infection and may be risk factors for increased risk of death.

关 键 词：慢性阻塞性肺疾病 老年人 白细胞介素-17 降钙素原 预后 

分 类 号：R563.9[医药卫生—呼吸系统]