医院获得性肺炎患者炎症因子的相关性研究

Study on the correlation of inflammatory factors in patients with hospital acquired pneumonia

目的观察白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子α(TNF-α)、降钙素原(PCT)、可溶性髓系细胞触发受体-1(sTREM-1)在医院获得性肺炎患者中的表达及意义,为尽早诊断及治疗医院获得性肺炎提供依据。方法选择2013年7月-2016年6月医院获得性肺炎患者196例作为HAP组,同期门诊体检健康志愿者195名为健康组,28d内存活的患者纳入HAP存活组,28d内死亡的患者纳入HAP死亡组,分别在诊断入组第1、4、7天、出院或死亡当日检测IL-6、IL-10、TNF-α、PCT、sTREM-1在HAP患者血清内的水平。结果 HAP组的sTREM-1、IL-6、IL-10、TNF-α、PCT水平均明显高于健康组,且HAP死亡组上述指标水平高于生存组;在治疗过程中,存活组HAP患者sTREM-1、IL-6、IL-10水平均低于死亡组,差异有统计学意义(P<0.05);存活组HAP患者sTREM-1、IL-6、IL-10水平随治疗时间的增加而逐渐减低,两两比较差异有统计学意义(P<0.05);存活组HAP患者TNF-α、PCT水平在治疗第1、4、7天及出院或死亡当日均低于死亡组,差异有统计学意义;存活组HAP患者TNF-α、PCT水平随治疗时间的增加而逐渐减低,两两比较有统计学意义。结论 sTREM-1、IL-6、IL-10、TNF-α、PCT水平在HAP患者的表达明显高于健康人群,其水平越高,炎症反应越严重,治疗预后越差。

OBJECTIVE To observe the expression and significance of interleukin-6（IL-6）,interleukin-10（IL-10）,tumor necrosis factor（TNF-α）,procalcitonin（PCT）and soluble triggering receptor-1（sTREM-1）in patients with hospital acquired pneumonia,so as to provide the basis for early diagnosis and treatment of hospital acquired pneumonia.METHODS A total of 196 cases of patients with hospital acquired pneumonia from Jul.2013 to Jun.2016 were selected as HAP group,195 healthy volunteers at the same period were selected as healthy group,survived patients within 28 dwere included in HAP survival group,and dead patients within 28 dwere included in HAP death group.Levels of IL-6,IL-10,TNF-α,PCT and sTREM-1in the serum of HAP patients were measured on the 1st,4th,7th day of hospitalization,discharge and death dead.RESULTS HAP group of levels of sTREM-1,IL-6,IL-10,TNF-α,and PCT of HAP group were significantly higher than those in healthy group,and the indexes in HAP death group were higher than those in HAP survival group.During the treatment,the levels of sTREM-1,IL-6and IL-10 in HAP survival group were significantly lower than those in HAP death group,and the difference was statistically significant（P〈0.05）.The levels of sTREM-1,IL-6and IL-10 in HAP survival group decreased gradually with the time of treatment,and the differences were statistically significant between each other（P0.05）.The levels of TNF-αand PCT in HAP survival group were lower than those in HAP death group on the 1st,4th,7th day of hospitalization,discharge and death,and the differences were statistically significant.The levels of TNF-αand PCT in HAP survival group decreased gradually with the time of treatment,and there were significant differences between each other.CONCLUSIONExpression levels of sTREM-1,IL-6,IL-10,TNF-α,and PCT expression in HAP patients were significantly higher than those in healthy people,The higher the level,the more severe the inflammatory response,and the worse of the treatment prognosis were obsewed.