血清白介素6含量的变化与APACHEⅡ评分在急性呼吸窘迫综合征患者中的临床意义

Clinical significance of changes of serum interleukin-6 content and APACHE Ⅱ score in patients with acute respiratory distress syndrome

目的 研究急性呼吸窘迫综合征（ARDS）患者血清中白介素6（IL-6）含量的变化以及与APACHEⅡ评分的相关性,并探讨其临床意义.方法 通过酶联免疫吸附实验检测76例ARDS患者发病时（0 h）和病程中（24 h、48 h、72 h）血清IL-6的变化,同时采用APACHEⅡ评分（0 h、24 h、48 h、72 h）对患者整体病情变化进行动态评价.结果 ARDS患者血清中IL-6水平较正常对照组显著升高（P＜0.01）,在死亡组血清IL-6水平亦明显高于生存组（P＜0.01）.无论在生存组或是死亡组,血清IL-6水平均和APACHEⅡ评分存在显著正相关（r=0.746,P=0.015; r=0.683,P=0.006）,且在ARDS病程中两者也有很好的相关性.结论 ARDS患者血清中升高的IL-6水平与肺损伤程度有关,结合APACHEⅡ评分,有助于对ARDS患者进行病情评估和预后判断,指导临床实践.

Objective To investigate the correlation between serum interleukin-6 （IL-6） level and APACHE Ⅱ score in patients with acute respiratory distress syndrome （ARDS）,and to evaluate its clinical significance. Methods Serum IL-6 level in 76 ARDS patients was measured by enzyme linked immunosorbent assay at onset （0 h） and during the progression of ARDS （24 h, 48 h, 72 h）. Dynamic APACHEⅡ score was also evaluated （0 h,24 h,48 h,72 h）. Results The serum IL-6 level in ARDS patients was significantly higher than that in normal control group （ P 〈0.01）,and the serum IL-6 level in death group was significantly higher than that in survival group （ P 〈0.01）. The serum IL-6 level was significantly positively correlated with APACHE Ⅱ score in survival group or death group （ r =0. 746, P =0. 015 ; r =0. 683, P =0. 006）. Conclusions The elevated serum IL-6 level in ARDS patients is correlated with the severity of lung injury,and appears to be a good marker to judge the prognosis of the disease combined with APACHE Ⅱ score.