IL⁃6、LDH、D-二聚体水平对恙虫病合并肺部感染患者的临床意义

Clinical significance of IL⁃6,LDH and D⁃dimer in evaluating tsutsugamushi disease

目的通过检测白介素-6(IL⁃6)、乳酸脱氢酶(LDH)、D-二聚体在恙虫病合并肺部感染患者血清中的表达水平,从而对患者病情进行预后评估,并分析其临床意义。方法选择海南医学院第一附属医院2018-2019年期间50名恙虫病合并肺部感染患者作为观察组,另选择羌虫病无肺部感染的患者50例作为对照组,分别采用化学发光法及速率法检测患者治疗前后血清中IL⁃6、LDH的浓度,采用免疫比浊法检测D-二聚体的浓度,并与对照组进行对比分析。绘制ROC曲线,观察三种指标与病情诊断和预后评估关系。结果观察组IL⁃6、LDH、D-二聚体三项指标均明显高于对照组,差异有统计学意义(P<0.05)。与急性期相比,恢复期患者血清中IL⁃6、LDH、D-二聚体的水平显著降低,差异有统计学意义(P<0.05)。联合检测的灵敏度、特异性、准确度、阳性预测值、阴性预测值均优于单个指标检测,差异有统计学意义(P<0.05)。结论检测恙虫病并肺部感染患者IL⁃6、LDH、D-二聚体浓度对病情诊断和预后评估具有重要的临床意义。

Objective To evaluate the prognosis of tsutsugamushi disease and analyze the clinical significance of serum levels of interleukin⁃6(IL⁃6),lactate dehydrogenase(LDH)and D⁃dimer.Methods Fifty tsutsugamushi disease patients with pulmonary infection in the First Affiliated Hospital of Hainan Medical College from 2018 to 2019 were selected as observation group,and another 50 patients without pulmonary infection in tsutsugamushi disease were selected as control group.The serum levels of IL⁃6 and LDH were detected by automatic chemiluminescence method and rate method before and after treatment,and D⁃dimer was detected by immunoturbidimetry.The concentration was compared with the control group.The ROC curve was drawn to observe the relationship between the three indicators and the diagnosis and prognosis of the disease.Results The three indexes of IL⁃6,LDH and D⁃dimer in the observation group were significantly higher than those in the control group(P<0.05).Compared with the acute phase,the levels of IL⁃6,LDH,and D⁃dimer in the serum of patients in the recovery phase were significantly reduced,and the difference was statistically significant(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of combined detection were better than those of single index detection(P<0.05).Conclusion Detecting the concentration of IL⁃6,LDH and D⁃dimer in patients with tsutsugamushi typhus complicated with pulmonary infection had important clinical significance in the diagnosis and prognosis evaluation of the disease.