下呼吸道感染肺炎支原体患者血清CRP、PCT、IL-6水平变化及临床意义

Changes and clinical significance of serum CRP,PCT and IL-6 in patients with lower respiratory tract infection caused by Mycoplasma pneumoniae

目的分析下呼吸道感染肺炎支原体(MP)患者血清C反应蛋白(CRP)、降钙素原(PCT)、白介素-6(IL-6)变化及临床意义。方法选取2017年1月至2019年11月成都医学院第二附属医院下呼吸道感染MP的患者126例(观察组)及同期入院体检健康志愿者35例(对照组),比较两组入院时血清CRP、PCT、IL-6水平,分析下呼吸道感染MP患者中不同病情、重症肺炎不同分期患者血清CRP、PCT、IL-6水平,Pearson法分析血清CRP、PCT、IL-6水平的相关性,绘制受试者工作特征曲线(ROC)评估血清CRP、PCT、IL-6水平对下呼吸道感染MP患者预后的预测价值。结果观察组入院时血清CRP、PCT、IL-6水平高于对照组,差异有统计学意义(P<0.05)。观察组中,重症肺炎患者入院时血清CRP、PCT、IL-6水平高于轻症肺炎患者,差异有统计学意义(P<0.05)。重症肺炎患者急性期血清CRP、PCT、IL-6水平高于恢复期,差异有统计学意义(P<0.05)。Pearson相关分析显示,下呼吸道感染MP患者血清CRP、PCT、IL-6水平两两存在正相关(rCRP、PCT=0.332,rCRP、IL-6=0.450,rPCT、IL-6=0.189,P<0.05)。血清CRP、PCT、IL-6水平及三者联合预测重症下呼吸道感染MP患者恢复的曲线下面积分别为0.794、0.828、0.773、0.892。结论下呼吸道感染MP患者随病情、分期增加,血清CRP、PCT、IL-6水平呈升高趋势,三者联合检测对重症患者预后有重要预测价值。

Objective To analyze the changes and clinical significance of serum C-reactive protein(CRP),procalcitonin(PCT)and interleukin-6(IL-6)in patients with lower respiratory tract infection caused by Mycoplasma pneumoniae(MP).Methods 126 patients with lower respiratory tract infection caused by MP(observation group)who were admitted to the hospital between January 2017 and November 2019 and 35 healthy volunteers(control group)who completed physical examination in the hospital during the same period were enrolled in the study.Serum CRP,PCT and IL-6 levels at admission were compared between the two groups.Levels of above indexes in subjects in different conditions and those with severe pneumonia at different stages were analyzed.Pearson method was used to analyze the correlation of serum CRP,PCT and IL-6 levels.The receiver operating characteristic(ROC)curves were drawn to evaluate the predictive value of serum CRP,PCT and IL-6 levels for the prognosis of patients with lower respiratory tract infection caused by MP.Results Serum CRP,PCT and IL-6 levels in observation group at admission were higher than those in control group(P<0.05).In the observation group,serum CRP,PCT and IL-6 levels were higher in patients with severe pneumonia than those with mild pneumonia,and higher in patients with severe pneumonia in acute phase than in recovery phase(P<0.05).Pearson correlation analysis showed that there was a positive correlation between any two of the 3 indexes in patients with lower respiratory tract infection by MP(rCRP,PCT=0.332,rCRP,IL-6=0.450,rPCT,IL-6=0.189,P<0.05).The areas under the curve(AUC)of serum CRP,PCT,IL-6 and their combination for predicting recovery of patients with severe lower respiratory tract infection caused by MP were 0.794,0.828,0.773 and 0.892,respectively.Conclusions Serum CRP,PCT and IL-6 levels in patients with lower respiratory tract infection caused by MP increased with their condition and stage.Serum CRP,PCT and IL-6 levels had predictive value for prognosis of critically ill patients.