慢性肺阻伴肺炎患者中血清IL-6、HPT、SAA检测价值比对研究

Comparative research on test value of serum level of IL-6,HPT,SAA in patients with a combination of COPD and pneumonia

目的:探讨白介素-6(interleukin-6,IL-6)、触珠蛋白(haptoglobin,HPT)、淀粉样蛋白(serum amyloid A,SAA)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)伴肺炎中的表达变化和诊断价值。方法:选取2009年9月-2010年9月我院患者72例,健康对照19例,按COPD无、缓解期、急性加重期和肺炎有、无两种因素组合分为6组,酶联免疫吸附试验检测其血清IL-6、HPT、SAA含量,双因素协方差分析其差异,并用ROC曲线比较评估其在肺炎中的价值。结果:COPD疾病进展中IL-6、HPT、SAA存在升高,并且肺炎患者高于未伴肺炎患者,差异具有显著统计学意义(P<0.01或P<0.05)。ROC曲线显示:IL-6的曲线下面积(AUC)(0.928,95%可信区间为0.875～0.982),高于HPT的AUC(0.905,95%可信区间为0.831～0.978)和SAA的AUC(0.853,95%可信区间为0.768～0.937)。结论:COPD患者中,IL-6是诊断肺炎的较佳指标。

Objective： To investigate the changes and diagnostic value of serum levels of interleukin-6（IL-6）,haptoglobin（HPT）,serum amyloid A（SAA） in patients with the combination of chronic obstructive pulmonary disease（COPD） and pneumonia.Methods： From September 2009 to September 2010,72 patients and 19 healthy individuals were selected and divided into 6 groups by 2 factors： pneumonia and COPD.Serum levels of IL-6,HPT,SAA were detected by enzyme linked immunosorbent assay（ELLSA）,and their differences were analyzed with double-factor covariance.The forecast value in pneumonia were evaluated by receiver operator characteristic（ROC） curve.Results： Serum levels of IL-6,HPT,SAA increased in the progress of COPD ,which were higher in patients with pneumonia than those in patients without pneumonia .The difference had statistical significance（P0.01 or P0.05）. The area under receiver characteristic curves（AUC）of serum levels of IL-6（0.928,95%CI 0.875～0.982） was higher than the AUC of serum levels of HPT（0.905,95%CI 0.831～0.978） and SAA（0.853,95%CI 0.768～0.937）.Conclusion： The present datas revealed that serum level of IL-6 is of great value for pneumonia in patients with COPD.