白介素-8水平与医院感染性肺炎关系的初步研究

PRELIMINARY STUDY ON THE RELATION BETWEEN INTERLEUKIN-8 LEVELS AND NOSOCOMIAL PNEUMONIA

目的 :探讨全身及局部白介素 - 8(IL - 8)水平与医院内感染性肺炎 (NosocomialPneumonia ,NP)发生的关系 ,为NP发病免疫机制的研究提供实验依据。方法 :以气管切开 (或插管 )病人为研究对象 ,按全国医院感染监控中心制订的标准确诊NP。用防污染标本刷 (PSB)采集下呼吸道分泌物 ,ELISA法测定下呼吸道分泌物及血清中IL - 8的水平。结果 :NP组较对照组血清IL - 8水平显著升高 ,第 5天分别为 ( 3.96± 2 .75) μg·L- 1和 ( 3.54± 1.82 ) μg·L- 1,第 7天分别为 ( 4 .4 6± 1.13) μg·L- 1和 ( 3.4 1± 1.56) μg·L- 1;下呼吸道分泌物中的IL - 8水平第 5天分别为( 4 .36± 2 .68) μg·L- 1和 ( 3.79± 1.89) μg·L- 1,第 7天分别为 ( 4 .99± 2 .0 1) μg·L- 1和 ( 3.58± 2 .2 3)μg·L- 1,且高于血清IL - 8水平。NP组在入院第 5～ 7天血清IL - 8呈上升趋势 ,与出现NP的时间相吻合。结论 :IL - 8可能是免疫炎症反应中重要的细胞因子 ,IL - 8水平升高可能是NP发生的早期标志 ,具有一定的诊断价值。

Objective:To study the immune mechanism of interleukin-8(IL-8) in the nosocomial pneumonia(NP),so as to provide experimental basis for the research of immune mechansm of NP.Methods:Patients who had mechanical ventilation or tracheostomy were selected and divided into NP group and control group. NP was diagnosed according to the standards for national hospitals made by the Monitoring Center for Inflammation. The secretion from the lower respiratory tracts was collected with protected specimen brush (PSB). The level of IL-8 in the the secretion and serum was measured with the method of ELISA.Results:The levels of serum IL-8 of NP group were obviously higher than those of control group〔(3.96±2.75)μg·L -1 and (3.54±1.82)μg·L -1 respectively on the 5 th admission day,(4.46±1.13)μg·L -1 and (3.41±1.56)μg·L -1 respectively on the 7 th d〕. The levels of IL-8 in the secretion from the lower respiratory tracts of NP group and control group were (4.36±2.68)μg·L -1 and (3.79±1.89) μg·L -1 respectively on the 5 th d, (4.99±2.01) μg·L -1 and (3.58±2.23)μg·L -1 respectively on the 7 th d, and were higher than those in serum. The increasing trend of IL-8 in NP patients on the 5 th～7 th d was in accordance with the time of occurrence of NP.Conclusion: IL-8 may be an important cytokine in immuno-inflammatory response and an early index for diagnosis of nosocomial pneumonia.