炎症因子在COVID-19危重症患者中的临床价值探讨

Clinical values of inflammatory factors in critically ill patients with COVID-19

目的对鄂州市中心医院新型冠状病毒肺炎(COVID-19)危重症及非危重症患者炎症因子进行分析,探讨炎症因子在危重症患者中的表达。方法选取2020年1月24日至2020年2月20日在该院确诊并接受治疗的COVID-19患者135例,分为非危重症组90例,危重症组45例。对两组初次及未次的炎症因子水平变化进行分析和比较。结果白细胞介素(IL)-6、降钙素原(PCT)、白细胞(WBC)、淋巴细胞百分比(L%)在两组间比较,差异均有统计学意义(P<0.05)。高敏C反应蛋白(hs-CRP)、红细胞沉降率比较,差异均无统计学意义(P>0.05)。对危重症死亡患者两次检测结果分析发现,IL-6、PCT、WBC、L%比较,差异有统计学意义(P<0.05),而hs-CRP和红细胞沉降率比较,差异无统计学意义(P>0.05)。对重症转治愈患者两次检测结果分析发现,CRP、WBC比较,差异有统计学意义(P<0.05)。而IL-6、L%、PCT、红细胞沉降率比较,差异无统计学意义(P>0.05)。IL-6、PCT、WBC、L%的受试者工作特征曲线(ROC曲线)下面积分别为0.875、0.749、0.885、0.864,联合检测ROC曲线下面积为0.974。结论IL-6、PCT、WBC、L%在COVID-19危重症患者的临床辅助诊断及病情监测中是较好的指标,联合检测意义更大。

Objective To analyze the inflammatory factors of critically ill and non-critically ill patients with corona virus disease(COVID-19)in the Central Hospital of Ezhou City,and to explore the expression of inflammatory factors in critically ill patients.Methods A total of 135 COVID-19 patients diagnosed and treated in this hospital from January 24 to February 20,2020 were selected and divided into non-critically ill group 90 cases and critically ill group 45 cases.The first and last levels of inflammatory factor were analyzed and compared between the two groups.Results Interleukin(IL)-6,procalcitonin(PCT),white blood cells(WBC)and lymphocyte percentage(L%)were compared between the two groups,and the differences were statistically significant(P<0.05).There was no statistically significant difference in high-sensitivity C-reactive protein(hs-CRP)and erythrocyte sedimentation rate(P<0.05).The two detection results of critically ill patients who died showed that the difference was statistically significant(P<0.05)in IL-6,PCT,WBC and L%,while the difference in hs-CRP and erythrocyte sedimentation rate was not statistically significant(P>0.05).The two results of severely ill converted to cured patients found that the difference between CRP and WBC was statistically significant(P<0.05).However,there was no statistically significant difference in IL-6,L%,PCT and erythrocyte sedimentation rate(P>0.05).The area under the receiver operating characteristic curve(ROC curve)of IL-6,PCT,WBC,L%were 0.875,0.749,0.885,0.864,respectively,and the area under the ROC curve for combined detection was 0.974.Conclusion IL-6,PCT,WBC,and L%are good indicators in the clinical auxiliary diagnosis and condition monitoring of COVID-19 critically ill patients,and joint monitoring is of greater significance.