重症肺炎患者外周血IL-6和IL-18水平的检测

Determination of peripheral blood IL-6 and IL-18 in patients with severe pneumonia

目的:探讨重症肺炎患者外周血白细胞介素-6(IL-6)和IL-18水平变化及其临床意义。方法:选择重症肺炎患者45例,临床肺部感染评分(CPIS)>6分15例,CPIS≤6分30例;常规治疗10 d后好转26例,恶化19例。选择同期收治的普通肺炎患者33例作为对照。重症肺炎组分别于治疗前和病程第3、7天,对照组于就诊当天抽取外周静脉血3 m L,放射免疫法测定IL-6,酶联免疫吸附法测定IL-18。结果:治疗前,重症肺炎组外周血IL-6和IL-18水平均高于对照组(t=7.672、8.376,P<0.05),CPIS高分组患者高于CPIS低分组(t=6.685、6.652,P<0.05)。治疗好转组和恶化组患者外周血IL-6和IL-18水平随病程进展均逐渐降低(F时间=17.921、10.533,P<0.05),好转组患者外周血IL-6和IL-18水平降低程度显著大于恶化组(F组间=10.186、8.276,P<0.05)。Pearson相关分析结果显示,治疗前重症肺炎患者外周血IL-6与IL-18水平呈显著正相关(r=0.517,P<0.001)。结论:外周血IL-6和IL-18水平可反映重症肺炎患者肺部感染的严重程度和预后。

Aim： To explore the levels of peripheral blood interleukin-6（IL-6） and IL-18 in patients with severe pneu-monia and the significance. Methods： A total of 45 patients with severe pneumonia were collected, out of which 15 cases with the clinical pulmonary infection score（CPIS） 〉 6 and 30 cases with CPIS≤6. After 10 days treatment, 26 cases were improved and 19 cases were deteriorating. Another 33 cases of ordinary pneumonia at the same period in the hospital were the control group. Peripheral blood IL-6 and IL-18 levels were determined by radioimmunoassay and enzyme-linked immu-nosorbent assay before the treatment and on the 3rd,7th day of the course of disease. Results： The peripheral blood IL-6 and IL-18 levels in severe pneumonia group before treatment were higher than those in the control group（t = 7. 672,8. 376, P 〈 0. 05）. The peripheral blood IL-6 and IL-18 levels in high CPIS group were higher than those in low CPIS group before treatment（t = 6. 685,6. 652,P 〈 0. 05）. The peripheral blood IL-6 and IL-18 levels in the improved group and deteriorating group gradually declined with time（Ftime = 17. 921,10. 533,P 〈 0. 05）,and the peripheral blood IL-6 and IL-18 levels and the decreased magnitude in the improved group were greater than those of the deteriorating group（Fgroup = 10. 186,8. 276, P 〈 0. 05）. Pearson correlation analysis showed that the peripheral blood IL-6 level was positively correlated with IL-18（r =0. 517,P 〈 0. 001） in severe pneumonia group before treatment. Conclusion： Peripheral blood IL-6 and IL-18 could reflect the severity of lung infection and prognosis of severe pneumonia patients.