机构地区:[1]华北医疗健康集团峰峰总医院重症医学科,河北邯郸056800 [2]华北医疗健康集团峰峰总医院麻醉科,河北邯郸056800 [3]邯郸市第四医院呼吸与危重症医学科,河北邯郸056200
出 处:《安徽医药》2025年第5期991-995,共5页Anhui Medical and Pharmaceutical Journal
基 金:河北省医学科学研究课题计划(20211703)。
摘 要:目的探究重症肺炎气管插管病人血清γ干扰素(IFN-γ)和CXC趋化因子配体10(CXCL10)表达水平与疾病转归的关系。方法选取2021年12月至2022年12月在华北医疗健康集团峰峰总医院就诊的重症肺炎气管插管病人82例即为观察组,同期选择在华北医疗健康集团峰峰总医院就诊的重症肺炎未进行气管插管病人82例为对照组;气管插管7 d后根据临床肺部感染评分(CPIS)对疾病转归进行评估,分为预后良好组50例,预后不良组32例。采用酶联免疫吸附分析(ELISA)检测血清中IFN-γ和CXCL10表达水平;Pearson法分析IFN-γ、CXCL10表达水平与CPIS评分的相关性;受试者操作特征曲线(ROC曲线)分析血清IFN-γ、CXCL10对重症肺炎气管插管病人预后的预测价值;采用多因素logistic回归分析重症肺炎气管插管病人疾病转归的影响因素。结果与对照组相比,观察组IFN-γ[(14.46±1.79)μg/L比(10.52±1.60)μg/L]、CXCL10[(7.27±1.09)μg/L比(5.02±0.63)μg/L]表达水平显著升高(P<0.05)。Pearson相关性分析显示,观察组血清IFN-γ、CXCL10表达水平与CPIS评分呈正相关关系(r_(S)=0.47、0.39,P<0.05)。与预后良好组相比,预后不良组IFN-γ、CXCL10水平以及CPIS评分显著升高(P<0.05);ROC曲线显示,两者联合预测重症肺炎气管插管病人预后不良的AUC高于IFN-γ、CXCL10单独预测的AUC值(Z=11.25,P<0.001;Z=10.08,P<0.001)。logistic回归分析结果显示,血清IFN-γ、CXCL10表达水平是重症肺炎气管插管病人疾病转归的影响因素(P<0.05)。结论血清IFN-γ、CXCL10与重症肺炎气管插管病人疾病转归密切相关,可作为疾病转归的潜在预测指标。Objective To investigate the relationship between the expression levels of serum interferon-γ(IFN-γ)and CXC chemokine ligand 10(CXCL10)in patients with severe pneumonia undergoing tracheal intubation and disease prognosis.Methods A total of 82 patients with severe pneumonia who underwent tracheal intubation at Fengfeng General Hospital of North China Medical Health Group from December 2021 to December 2022 were collected as the study group.During the same period,82 with severe pneumonia without tracheal intubation at Fengfeng General Hospital of North China Medical Health Group were collected as the control group.After 7 days of tracheal intubation,the disease progression was evaluated based on the Clinical Pulmonary Infection Score(CPIS),and they were grouped into a good prognosis group of 50 cases and a poor prognosis group of 32 cases.Enzyme linked immunosorbent assay(ELISA)was applied to detect the expression levels of IFN-γand CXCL10 in serum;Pearson method was applied to analyze the correlation between IFN-γ,CXCL10 expression levels and CPIS scores;receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum IFN-γand CXCL10 on the prognosis of patients with severe pneumonia undergoing tracheal intubation;multivariate logistic regression was applied to analyze the influencing factors of disease outcome in patients with severe pneumonia undergoing tracheal intubation.Results Compared with the control group,the expression levels of IFN-γ[(14.46±1.79)μg/L vs.(10.52±1.60)μg/L]and CXCL10[(7.27±1.09)μg/L vs.(5.02±0.63)μg/L]in the study group were obviously higher(P<0.05).Pearson correlation analysis showed that the expression levels of serum IFN-γand CXCL10 in the study group were positively correlated with CPIS score(r_(S)=0.47,0.39,P<0.05).Compared with the good prognosis group,the IFN-γ,CXCL10 levels,and CPIS score in the poor prognosis group were obviously higher(P<0.05);ROC curve showed that the AUC of combined prediction for poor prognosis in patients with
关 键 词:肺炎 气管插管 Γ干扰素 CXC趋化因子配体10 转归
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