炎症细胞因子在慢性阻塞性肺疾病并发肺炎中的诊断效能分析  

Analysis on diagnostic efficiency of inflammatory cytokines in chronicobstructive pulmonary disease complicating pneumonia

作　　者：李伟 齐栩[1] 任重远 赵玉国 LI Wei;QI Xu;REN Zhongyuan;ZHAO Yuguo(Department of Respiratory and Critical Care Medicine,First Affiliated Hospital of Nanjing Medical University/Jiangsu Provincial People’s Hospital,Nanjing,Jiangsu 210029,China;Department of Respiratory Medicine,Lishui District People’s Hospital/Lishui Branch Hospital,Affiliated Zhongda Hospital,Southeast University,Nanjing,Jiangsu 211200,China)

机构地区：[1]南京医科大学第一附属医院/江苏省人民医院呼吸与危重症医学科,南京210029 [2]南京市溧水区人民医院/东南大学附属中大医院溧水分院呼吸内科,南京211200

出　　处：《重庆医学》2024年第22期3385-3388,共4页Chongqing Medical Journal

基　　金：江苏省卫生健康委员会科研项目(H2019029)。

摘　　要：目的探讨炎症细胞因子在慢性阻塞性肺疾病(COPD)并发肺炎中的诊断效能。方法选取2021年7月至2023年8月南京医科大学第一附属医院收治的215例COPD患者为研究对象,将COPD并发肺炎患者纳入观察组(n=87),单纯COPD患者纳入对照组(n=128)。对比两组炎症细胞因子[降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、WBC]及肺功能指标[呼气峰值流速(PEF)、第1秒用力呼吸量(FEV1)、用力肺活量(FVC)]变化情况,分析炎症细胞因子在COPD并发肺炎中的诊断效能,以及COPD并发肺炎患者炎症细胞因子与肺功能的相关性。结果观察组PCT、CRP、IL-6、TNF-α、WBC水平明显高于对照组(P<0.05),FEV1、FVC、PEF水平明显低于对照组(P<0.05)。PCT、CRP、IL-6、TNF-α、WBC联合检测对COPD并发肺炎的诊断效能较好,灵敏度为90.80%,特异度为90.62%,曲线下面积(AUC)为0.967。相关性分析显示,COPD并发肺炎患者PCT、CRP、IL-6、TNF-α、WBC水平与FEV1、FVC、PEF水平呈负相关(P<0.05)。结论COPD并发肺炎患者存在典型的炎症反应和肺功能恶化,相关炎症指标联合检测对其诊断效能较好。Objective To explore the diagnostic efficiency of inflammatory cytokines in chronic obstructive pulmonary disease(COPD)complicating pneumonia.Methods A total of 215 patients with COPD admitted and treated in the First Affiliated Hospital of Nanjing Medical University from July 2021 to August 2023 were selected as the study subjects.According to whether or not complicating pneumonia,the patients with complicating pneumonia were included in the observation group(n=87)and those with simple COPD were included in the control group(n=128).The changes of inflammation cytokines[procalcitonin(PCT),tumor necrosis factor-α(TNF-α),C reactive protein(CRP),interleukin-6(IL-6),WBC]and lung function indicators[peak expiratory flow rate(PEF),breathing volume in the first second(FEV1),forced vital capacity(FVC)]were compared between the two groups.The diagnostic efficiency of inflammatory cell factors in COPD complicating pneumonia as well as the correlation between the inflammatory cytokines and the lung function in the patients with COPD complicating pneumonia were analyzed.Results The levels of PCT,CRP,IL-6,TNF-αand white blood cell count(WBC)in the observation group were significantly higher than those in the control group(P<0.05),and FEV1,FVC and PEF in the observation group were significantly lower than those in the control group(P<0.05).The diagnostic efficiency of joint detection of PCT,CRP,IL-6,TNF-αand WBC in diagnosing COPD complicating pneumonia was better,the sensitivity was 90.80%,the specificity was 90.62%,the area under the curve(AUC)was 0.967.The correlation analysis revealed that the PCT,CRP,IL-6,TNF-αand WBC levels in the patients with COPD complicating pneumonia were negatively correlated with FEV1,FVC and PEF levels(P<0.05).Conclusion The patients with COPD complicating pneumonia exhibit the typical inflammatory responses and deterioration of lung function.The combined detection of relevant inflammatory indicators has the good diagnostic efficiency for it.

关 键 词：慢性阻塞性肺病 肺炎 炎症细胞因子 肺功能 相关性 

分 类 号：R563.9[医药卫生—呼吸系统]