外周血炎症因子水平与重症肺炎并发急性呼吸窘迫综合征相关性分析

CORRELATION ANALYSIS OF INFLAMMATORY FACTORS IN PERIPHERAL BLOOD WITH SEVERE PNEUMONIA COMPLICATED WITH ARDS

目的探讨外周血炎症因子血清肿瘤坏死因子(TNF-α)、白介素6(IL-6)、白介素10(IL-10)及高迁移率族蛋白B1(HMGB1)水平与重症肺炎并发急性呼吸窘迫综合征(ARDS)的相关性。方法选取2019年1月—2020年6月湖南省长沙市第四医院重症医学科收治的重症肺炎65例,根据有无并发ARDS分为并发组(31例)和未并发组(34例),并于同期另选取32例健康体检者为对照组。比较各组受试者的外周血炎症因子水平,并分析TNF-α、IL-6、IL-10及HMGB1水平与重症肺炎并发ARDS的相关性。结果观察组患者血清TNF-α、IL-6、IL-10和HMGB1水平均明显高于对照组,差异有统计学意义(P<0.05);重症肺炎患者中并发ARDS组的血清TNF-α、IL-6和HMGB1水平显著高于未并发组,而IL-10水平明显低于未并发组,差异均有统计学意义(P<0.05);重症肺炎患者血清TNF-α、IL-6、IL-10及HMGB1水平预测重症肺炎患者并发ARDS的ROC曲线显示,4项指标的ROC曲线下与坐标轴围成的面积(AUC)值、敏感度和特异度均较高。结论重症肺炎患者血清TNF-α、IL-6、IL-10及HMGB1水平与其并发ARDS密切相关,这些指标可用于评估患者病情发展程度,指导临床治疗及改善预后。

Objective To investigate the correlation between the levels of inflammatory cytokines TNF-,IL-6,IL-10 and HMGB1 and ARDS complicated with severe pneumonia.Methods A total of sixty five cases of severe pneumonia admitted to the Department of critical care,department of critical care medicine,Changsha Fourth Hospital from January 2019 to June 2020 were selected and divided into a concurrent group(31 cases)and a non-concurrent group(34 cases)according to whether ARDS was complicated or not.Another 32 healthy patients were selected as the control group during the same period.The levels of inflammatory factors in peripheral blood of each group were compared,and the correlation between TNF-,IL-6,IL-10 and HMGB1 levels and ARDS complicated with severe pneumonia was analyzed.Results Serum LEVELS of TNF-,IL-6,IL-10 and HMGB1 in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The serum LEVELS of TNF-,IL-6 and HMGB1 in ARDS group with severe pneumonia were significantly higher than those in non-ards group,while the levels of IL-10 were significantly lower than those in non-ARDS group,with statistically significant differences(P<0.05).The ROC curve of serum TNF-,IL-6,IL-10 and HMGB1 levels in patients with severe pneumonia predicting ARDS showed that the AUC value,sensitivity and specificity of the four indicators were all high.Conclusion Serum LEVELS of TNF-,IL-6,IL-10 and HMGB1 in patients with severe pneumonia are closely related to ARDS.These indicators can be used to evaluate the progression of patients’disease,guide clinical treatment and improve prognosis.