监测重症肺炎患者血清及支气管肺泡灌洗液中炎症因子水平变化

Monitoring of Inflammatory Factor Level in Serum and BALF in Patients With Severe Pneumonia

目的通过动态检测炎症因子TNF-α、IL-6、IL-10在肺炎不同病程中水平变化情况探究细胞因子水平变化与重症肺炎疾病进程的关系。方法采用ELISA试剂盒法通过在同一时间点对65例重症肺炎患者的血清及支气管肺泡灌洗液样本中TNF-α、IL-10、IL-6的水平进行动态监测。结果 CPIS高分组(即重症肺炎病情加重患者)血清中TNF-α水平值相对于低分组患者的明显较高(P<0.05),其差异具有统计学意义。高分组随着病程不断推进,血清中IL-10表达量快速增高,在第7天已经为入院第1天的1.14倍,高分组及CPIS低分组IL-6含量随着病程延长呈现下降趋势,且在第4天及第7天两组间组间比较P>0.05无显著性差异。并且无论在高分组、低分组支气管肺泡灌洗液中,还是在病人的血清中TNF-α,IL-6,IL-10等细胞因子的水平变化趋势一致,氮含量总体均值较血清高。结论重症肺炎患者血清及支气管肺泡灌洗液中的相关细胞因子可衡量疾病严重程度。TNF-α、IL-6、IL-10水平越l高,肺炎越严重。

Objective To dynamically monitor the changes of the inflammatory factors TNF-α, IL-6 and IL-10 in different cour-ses of pneumonia and to explore the correlation between the changes of these facors and the progression of the disease. Methods The levels of TNF-α, IL-6 and IL-10 in serum and BALF samples of 65 patients with severe pneumonia were dynamically monitored at the same time with ELISA. Results The TNF-α level in serum of the CPIS high score group was remarkably higher than that of the low score group with statistical difference （P〈0. 05）. In the high score group, with the progression of the disease, IL-10 expression in se-rum increased rapidly, which , on the 7th day, was already 1. 14 times as much as that on the 1st day in hospital. A downward trend appeared in the content of IL-10 in both CPIS high score group and low score group with the extension of the course. There were no significant difference in expressions on the 4th day and 7th day between the two groups （P〉0. 05）. The change of cytokines, TNF-α, IL-6, IL-10, in BALF and serum in both groups shared the same trend. The total average of nitrogen content was higher than serum. Conclusion Related cytokines in serum and BALF in patients with severe pneumonia can be an indicator of the disease. The higher the levels of TNF-α, IL-6 and IL-10 are, the more severe pneumonia is.