IL-1β、TLR4、CRP与新冠肺炎危重程度(CURB-65分级)相关性及预后影响因素分析

Correlation and the prognostic factors analysis of the novel coronaviruspneumonia severity (CURB-65 grade) with IL-1β,TLR4 and CRP

目的探讨C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、Toll样受体4(TLR4)与新型冠状病毒肺炎(简称新冠肺炎)危重程度(CURB-65分级)相关性及预后影响因素。方法选取2020年1-4月徐州地区30例新冠肺炎患者,空腹抽取肘静脉血,经酶联免疫吸附法测定CRP、IL-1β、TLR4水平,并给予对应治疗。分析不同危重程度、不同预后新冠肺炎患者血清IL-1β、TLR4、CRP水平,血清指标与新冠肺炎危重程度关联性不同预后患者一般资料,以及不同预后患者预后影响因素。结果不同危重程度患者血清IL-1β、TLR4、CRP水平间差异有统计学意义(P<0.05),且中度者血清IL-1β、TLR4、CRP水平高于轻度者,重度者血清IL-1β、TLR4、CRP水平高于中度者和轻度者(P<0.05);血清IL-1β、TLR4、CRP水平与新冠肺炎危重程度呈正相关(r=0.703、0.641、0.670,P<0.05);预后良好者血清IL-1β、TLR4、CRP水平低于预后不良者(P<0.05);年龄≥60岁、APACHEⅡ评分≥20分、合并呼吸衰竭、合并心力衰竭、发生水电解质紊乱或酸碱失衡、合并基础疾病为影响新冠肺炎患者预后情况的重要因素(P<0.05)。结论不同危重程度、不同预后新冠肺炎患者血清IL-1β、TLR4、CRP水平间存在明显差异,两者间具有密切关联性,且年龄、APACHEⅡ评分及合并呼吸衰竭、心力衰竭等是影响新冠肺炎预后的重要危险因素。

Objective To investigate the correlation of the COVID-19 severity(CURB-65 classification)and the prognostic factors with C reactive protein(CRP),interleukin-1β(IL-1β)and Toll like receptor 4(TLR4).Methods A total of 30 patients with COVID-19 in Xuzhou area from January 2020 to April 2020 were selected.Fasting blood samples from elbow vein were collected and the levels of CRP,IL-1βand TLR4 were measured by Enzyme-Linked ImmunoSorbent Assay,and the patients were given corresponding treatments.Serum IL-1β,TLR4 and CRP levels in COVID-19 patients with different critical degrees and prognosis were recorded,the association between severity of COVID-19 and serum indexes,general data of different prognosis patients and prognostic factors of different prognosis patients were analyzed.Results The levels of IL-1β,TLR4 and CRP in patients with different severity were significantly different(P<0.05).The serum levels of IL-1β,TLR4 and CRP in moderate group were higher than those in mild group,and the serum levels of IL-1β,TLR4 and CRP in severe group were higher than those in moderate and mild group(P<0.05).The severity of COVID-19 positively correlated with serum IL-1β,TLR4 and CRP levels(r=0.703,0.641,0.670,P<0.05).In addition,the serum IL-1,TLR4 and CRP levels of patients with good prognosis were significantly lower than those of poor prognosis(P<0.05).Patients over 60 years old and APACHEⅡscore over 20 points,based on respiratory failure or heart failure,and water electrolyte disorder or acid-base imbalance and basic diseases were important factors affecting the prognosis of COVID-19 patients(P<0.05).Conclusion COVID-19 patients with different severity and prognosis have significant differences in serum IL-1β,TLR4 and CRP levels.Close correlations are found between them.Meantime,age,APACHEⅡscore,respiratory failure and heart failure are important risk factors for prognosis of new crown pneumonia.