血清suPAR、D-二聚体及IL-6在重症肺炎患者中的表达及临床意义

Expression and clinical significance of serum suPAR,D-dimer,and IL-6 in patients with severe pneumonia

目的探讨血清可溶性尿激酶型纤溶酶原激活物受体(su PAR)、D-二聚体(D-dimer)及白介素(IL-6)IL-6在重症肺炎患者中的表达及临床意义。方法选择2014年8月至2017年8月我院接诊的40例重症肺炎和40例普通肺炎患者进行研究,并选择同期于我院进行体检的健康人群40例作为对照组。分析血清su PAR、D-dimer、IL-6在重症肺炎中的表达意义及诊断价值。结果重症肺炎组血清su PAR、D-dimer、IL-6均明显比普通肺炎组及对照组高,重症肺炎组肺炎严重指数(PSI)评分明显高于普通肺炎组,差异具有统计学意义(P<0.05);在logistic回归分析中显示,血清su PAR、D-dimer、IL-6均是重症肺炎的发病危险因素(P<0.05);联合联合检测su PAR+D-dimer+IL-6诊断效能[曲线下面积(AUC)=0.933,95%CI:0.880-0.986]均明显高于su PAR(AUC=0.779,95%CI:0.671-0.886)、D-dimer(AUC=0.788,95%CI:0.678-0.897)、IL-6(AUC=0.764,95%CI:0.655-0.874)单独检测,比较均具有显著差异(Z=-2.51、-2.33、-2.72,P<0.05);联合检测su PAR+D-dimer+IL-6的特异度、准确度分别为91.82%、93.14%,明显高于各指标单独检测结果。结论在重症肺炎患者中,血清su PAR、D-dimer、IL-6明显增加,和疾病严重程度呈正相关,且联合检测血清su PAR、D-dimer、IL-6具有较高的特异度、准确度,临床应用价值高。

Objective To study the expression and clinical significance of serum soluble urokinase type plasminogen activator receptor（ su PAR）,D-dimer and interleukin-6（ IL-6） in patients with severe pneumonia.Methods 40 cases of severe pneumonia and 40 cases of general pneumonia from August 2014 to August 2017 in our hospital were selected as research objects,and 40 healthy people were selected as the control group. The expression and diagnostic value of serum su PAR,D-dimer and IL-6 in patients with severe pneumonia were analyzed. Results The serum levels of su PAR,D-dimer and IL-6 in the severe pneumonia group were significantly higher than those in the ordinary pneumonia group and the control group,the pneumonia severity index（ PSI） score in the severe pneumonia group were significantly higher than those in the ordinary pneumonia group,and the difference was statistically significant（ P〈0. 05）. The logistic regression analysis showed that serum su PAR,D-dimer and IL-6 were the risk factors of severe pneumonia（ P〈0. 05）. The combined detection of su PAR ＋ D-dimer ＋ IL-6 [Area under the curve（ AUC） = 0. 933,95% CI： 0. 880 ~ 0. 986]were significantly higher than that of su PAR（ AUC = 0. 779,95% CI：0. 671 ~ 0. 886）,D-dimer（ AUC = 0. 788,95% CI： 0. 678 ~ 0. 897）,and IL-6（ AUC = 0. 764,95% CI： 0. 655 ~0. 874） detection alone（ Z =-2. 51,-2. 33,-2. 72,P〈0. 05）. The specificity and accuracy of combined detection of su PAR ＋ D-dimer ＋ IL-6 were 91. 82% and 93. 14%,respectively,which were significantly higher than the results of individual detection of each index. Conclusion In patients with severe pneumonia,serum su PAR,D-dimer and IL-6 increase significantly,and are positively correlated with disease severity. The joint detection of serum su PAR,D-dimer and IL-6 has higher specificity,accuracy and clinical value.