老年重症肺炎患者TNF-α及IL-10的表达水平对预后的评估价值

Changes and prognostic value of TNF-α and IL-10 in elderly patients with severe pneumonia

目的探讨肿瘤坏死因子-α(TNF-α)及白介素-10(IL-10)对老年重症肺炎病情严重程度及预后的评估价值。方法选取86例老年重症肺炎患者为重症肺炎组、70例普通肺炎老年患者为非重症肺炎组、65例体检正常的健康老年人为正常对照组。采用酶联免疫吸附法检测并比较三组TNF-α及IL-10血浆水平。根据临床转归情况将86例重症肺炎患者分为死亡组与存活组,比较两组TNF-α与IL-10血浆水平的比值的动态变化情况。结果重症肺炎组患者确诊后24 h内血浆TNF-α、IL-10水平及TNF-α/IL-10均明显高于非重症肺炎组和正常对照组(P<0.05);非重症肺炎组血浆TNF-α、IL-10水平及TNF-α/IL-10明显高于正常对照组(P<0.05);入院后第1、3、5、7天死亡组TNF-α与IL-10血浆水平的比值一直处于较高水平,而存活组则逐渐下降,下降幅度明显低于存活组(P<0.05)。结论血浆TNF-α及IL-10水平不仅可反映老年重症肺炎患者机体炎症反应状况,也可以作为判断疾病预后的早期指标,对临床治疗有一定参考价值。

Objective To explore the changes and prognostic value of tumor necrosis factor-α （TNF-α） and interleukin-10（IL- 10） in elderly patients with severe pneumonia. Methods 86 cases of elderly patients with severe pneumonia were chosen as severe pneumonia group, 70 cases of elderly patients with common pneumonia as non-severe pneumonia group, 65 cases of healthy older adults as normal control group. The plasma TNF-α and IL-10 levels were detected by enzyme-linked immunosorbent method. 86 cases of elderly patients with severe pneumonia were divided into death group and survival group according to clinical outcome, and the dynamic changes of the ratio of plasma TNF-α and IL-10 levels were compared in two groups. Results The plasma TNF-α and IL-10 levels, the ratio of plasma TNF-α and IL-10 levels within 24 h after confirmed in severe pneumonia group were higher than those in non-severe pneumonia group and normal control group （P〈 0.05）. The ratio of plasma TNF-α and IL-10 levels was at a high level at 1 d, 3 d, 5 d, 7 d after admission in death group, but had a gradual decline in survival group; and the falling ranges were higher than those in death group （P〈0.05）. Conclusion The plasma TNF-α and IL-10 levels could reflect the body＇s inflammatory response in elderly patients with severe pneumonia, and as an early indicator of the prognostic evaluation of disease.