IL-6和IL-18水平预测重症肺炎患者肺部感染严重程度和预后的可行性研究

Research of feasibility by IL-6 and IL-18 levels in predication of pulmonary infection severity and prognosis in severe pneumonia patients

目的分析外周血白细胞介素-6(IL-6)和白细胞介素-18(IL-18)水平预测重症肺炎患者肺部感染严重程度及预后的可行性。方法 50例重症肺炎患者为观察组,另选取同期普通肺炎患者40例为对照组。治疗10 d后对临床疗效进行判断,比较治疗前观察组与对照组患者的IL-6与IL-18水平,比较重症肺炎不同感染程度患者治疗前IL-6、IL-18的水平及治疗后好转组与恶化组患者在治疗前、第3天、第7天的IL-6、IL-18水平。结果治疗前,观察组患者外周血IL-6为(61.67±18.53)ng/L、IL-18为(83.54±16.77)ng/L,均显著高于对照组的(35.64±12.33)、(55.81±13.18)ng/L,差异具有统计学意义(P<0.05)。治疗前,CPIS高分组患者IL-6为(83.63±24.11)ng/L、IL-18为(103.02±23.68)ng/L显著高于CPIS低分组的(50.40±17.55)、(72.58±15.65)ng/L,差异具有统计学意义(P<0.05)。与治疗前比较,好转组患者第3天的IL-6、IL-8水平显著降低,差异具有统计学意义(P<0.05);与治疗前及第3天比较,好转组患者第7天IL-6及IL-8水平显著降低,差异具有统计学意义(P<0.05)。与恶化组同时间比较,好转组患者第3天及第7天IL-6、IL-8水平显著降低,差异具有统计学意义(P<0.05)。结论 IL-6与IL-18的水平作为预测重症肺炎患者肺部感染的严重程度和预后的指标具有较高的临床价值。

Objective To analyze feasibility by peripheral blood interleukin-6 (IL-6) and interleukin-18 (IL-18) levels in predication of pulmonary infection severity and prognosis in severe pneumonia patients. Methods There were 50 patients with severe pneumonia as observation group and 40 patients with common pneumonia at the same period as control group. Clinical effects were evaluated after 10-d treatment. Comparison was madeon IL-6 and IL-18 levels before treatment between the two groups. IL-6 and IL-18 levels in severe pneumonia patients with different infection degree were compared before treatment, along with those between improvement group and deterioration group before and in 3 and 7 d of treatment. Results Before treatment, the observation group had peripheral blood IL-6 as (61.67±18.53) ng/L and IL-18 as (83.54±16.77) ng/L, which were obviouslyhigher than (35.64±12.33) and (55.81±13.18) ng/L in the control group, and their difference had statisticalsignificance (P<0.05). Before treatment, high CPIS score group had IL-6 as (83.63±24.11) ng/L and IL-18as (103.02±23.68) ng/L, which were much higher than (50.40±17.55) and (72.58±15.65) ng/L in low CPISscore group, and their difference had statistical significance (P<0.05). Comparing with those before treatment,improvement group had much lower IL-6 and IL-18 levels in 3 d of treatment, and the difference had statisticalsignificance (P<0.05). Comparing with those before and in 3 d of treatment, improvement group had much lowerIL-6 and IL-18 levels in 7 d of treatment, and the difference had statistical significance (P<0.05). Comparing with deterioration group, improvement group had much lower IL-6 and IL-18 levels in 3 and 7 d of treatment, and the difference had statistical significance (P<0.05). Conclusion In predication of pulmonary infection severity and prognosis in severe pneumonia patients, IL-6 and IL-18 levels contains high clinical value.