HNL、IL-1Ra/IL-1β比值联合炎症标志物诊断急性细菌性肺炎与病毒性肺炎的价值及与病情的关系  

The Value of HNL,IL-1Ra/IL-1βRatio Combined with Inflammatory Markers in the Diagnosis of Acute Bacterial Pneumonia and Viral Pneumonia and Its Relationship with Disease Severity

作　　者：赵博华 王宪灵 李亚娟 雷达鑫 ZHAO Bo-hua;WANG Xian-ling;LI Ya-jung;LEI Da-xin(Department of Clinical Laboratory,the 980th Hospital of the Chinese People’s Liberation Army Joint Logistic Support Force,Shijiazhuang 050000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八〇医院检验科,石家庄050000

出　　处：《南昌大学学报（医学版）》2024年第5期74-80,共7页Journal of Nanchang University：Medical Sciences

基　　金：河北省重点研发计划项目(21083380615D)。

摘　　要：目的探讨中性粒细胞载脂蛋白(HNL)、白细胞介素-1受体拮抗因子(IL-1Ra)/白细胞介素-1β(IL-1β)比值辅助炎症标志物诊断急性细菌性肺炎与病毒性肺炎的价值及与病情的关系。方法回顾性选取2021年9月至2023年5月中国人民解放军联勤保障部队第九八〇医院收治的急性肺炎患者228例为研究组[根据病原体培养结果分为细菌亚组105例与病毒亚组123例;根据急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分结果将细菌亚组分为轻度32例、中度50例及重度23例,病毒亚组分为轻度36例、中度66例及重度21例],选取同期健康体检志愿者114例为对照组。比较研究组与对照组、细菌亚组与病毒亚组及不同病情程度患者HNL、IL-1Ra/IL-1β比值、炎症标志物[C反应蛋白(CRP)、降钙素原(PCT)]水平,并分析各指标对细菌性肺炎与病毒性肺炎的诊断价值与病情的关系。结果研究组血清HNL、IL-1β、CRP、PCT高于对照组,IL-1Ra、IL-1Ra/IL-1β比值低于对照组(P<0.05);细菌亚组血清HNL、IL-1β、CRP、PCT高于病毒亚组,IL-1Ra、IL-1Ra/IL-1β比值低于病毒亚组(P<0.05)。受试者工作特性曲线(ROC)显示,血清HNL、IL-1Ra/IL-1β比值、CRP、PCT联合诊断肺炎、细菌性肺炎以及病毒性肺炎具有较高的诊断价值。细菌亚组重度患者血清HNL、IL-1β、CRP、PCT水平>中度患者>轻度患者,IL-1Ra、IL-1Ra/IL-1β比值<中度患者<轻度患者,差异有统计学意义(P<0.05);病毒亚组重度患者血清HNL、IL-1β、CRP水平>中度患者>轻度患者,IL-1Ra、IL-1Ra/IL-1β比值<中度患者<轻度患者,差异有统计学意义(P<0.05);相关性分析结果显示,血清HNL、CRP与细菌性肺炎、病毒性肺炎病情程度呈正相关,IL-1Ra/IL-1β比值与之呈负相关,PCT与细菌性肺炎病情程度呈正相关(P<0.05)。结论血清HNL、IL-1Ra/IL-1β比值、CRP、PCT水平与细菌性肺炎、病毒性肺炎病情程度均具有一定相关性,联合检测可Objective To explore the value of neutrophil apolipoprotein(HNL)and interleukin-1 receptor antagonist(IL-1Ra)/interleukin-1β(IL-1β)ratio as auxiliary inflammatory markers to diagnose acute bacterial and viral pneumonia,and its their relationship with disease severity.Methods A retrospective study was conducted on 228 patients with acute pneumonia admitted to our hospital from September 2021 to May 2023,serving as the study group.According to the pathogen culture results,it was divided into a bacterial subgroup of 105 cases and a viral subgroup of 123 cases.According to the Acute Physiology and Chronic Health Evaluation SystemⅡ(APACHEⅡ)scoring results,the bacterial subgroup was classified into 32 mild cases,50 moderate cases,and 23 severe cases,whereas the viral subgroup was classified into 36 mild cases,66 moderate cases,and 21 severe cases.114 healthy volunteers who underwent physical examinations during the same period were established as the control group.The study compared the levels of HNL,IL-1Ra/IL-1βratio,and inflammatory markers[C-reactive protein(CRP),procalcitonin(PCT)]between the study group and the control group,the bacterial subgroup and the viral subgroup,and patients with different levels of disease severity.The diagnostic value of each indicator for bacterial pneumonia and viral pneumonia and its relationship with disease severity were analyzed.Results The levels of serum HNL,IL-1β,CRP,and PCT in the study group were higher than those in the control group,while the IL-1Ra and IL-1Ra/IL-1βratio were lower than those in the control group,with significant differences(P<0.05).The levels of serum HNL,IL-1β,CRP,and PCT in the bacterial subgroup were higher than those in the viral subgroup,while the IL-1Ra and IL-1Ra/IL-1βratio were lower than those in the viral subgroup,with significant differences(P<0.05).The receiver operating characteristic(ROC)curve showed that the combination of serum HNL,IL-1Ra/IL-1βratio,CRP,and PCT had a high diagnostic value in the diagnosis of pneumonia,bacterial p

关 键 词：中性粒细胞载脂蛋白 白细胞介素-1受体拮抗因子/白细胞介素-1β比值 炎症标志物 急性细菌感染 急性病毒感染 肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]