重型新型冠状病毒肺炎与普通重症肺炎患者炎症因子水平分析

Analysis of the levels of inflammatory cytokines in patients with severe corona virus disease 2019 and normal infectious severe pneumonia

目的探讨血清炎症因子在重型新型冠状病毒肺炎(简称新冠肺炎)患者和其他重症肺炎(非新冠肺炎)患者中的表达差异。方法该研究为回顾性研究,将2020年1月27日至2020年2月29日该院收治的重型新冠肺炎患者125例作为重型新冠肺炎组,选取2018年11月1日至2020年12月31日该院收治的其他重症肺炎患者31例作为普通重症肺炎组。比较两组患者入院24 h内首次白细胞计数(WBC)、中性粒细胞绝对值(NEUT#)、淋巴细胞绝对值(LYM#)、中性粒细胞绝对值与淋巴细胞绝对值比值(NLR)、血小板计数(PLT)、纤维蛋白原(FIB)、D-二聚体、超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-1β、白细胞介素2受体(IL-2R)、IL-6、IL-8、IL-10、肿瘤坏死因子(TNF)-α、基础疾病等临床资料,并观察患者的临床结局。结果重型新冠肺炎组WBC、NEUT#、NLR、D-二聚体、hs-CRP、IL-1β、IL-2R、IL-6、IL-8、IL-10和TNF-α低于普通重症肺炎组,LYM#、PLT和FIB高于普通重症肺炎组,差异有统计学意义(P<0.05)。重型新冠肺炎组死亡患者NEUT#、NLR、IL-1β、IL-2R、IL-6、IL-8和IL-10低于普通重症肺炎组死亡患者,差异有统计学意义(P<0.05),而WBC、LYM#、PLT、FIB、D-二聚体、hs-CRP和TNF-α在两组死亡患者中比较,差异无统计学意义(P>0.05)。结论重型新冠肺炎患者体内炎症因子水平低于普通重症肺炎患者,监测肺炎患者炎症因子水平有助于临床的诊断和治疗。

Objective To investigate the differences on the expression of serum inflammatory cytokines in patients with severe corona virus disease 2019(COVID-19)and patients with infectious normal severe pneumonia(non-novel coronavirus infection).Methods Retrospective study,a total of 125 patients with severe COVID-19 admitted in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 27,2020 to February 29,2020 were selected as severe COVID-19 group,a total of 31 patients with normal infectious severe pneumonia from November 1,2018 to December 31,2020 were selected as non-novel coronavirus severe pneumonia group.White blood cell count(WBC),neutrophil absolute value(NEUT#),lymphocyte absolute value(LYM#),neutrophil lymphocyte ratio(NLR),platelet count(PLT),fibrinogen(FIB),D-dimer,hypersensitive C-reactive protein(hs-CRP)and interleukin(IL)-1β,interleukin 2 receptor(IL-2 R),IL-6,IL-8,IL-10 and tumor necrosis factor(TNF)-α,basic diseases and other clinical data were obtained within 24 hours after admission and compared,and the clinical outcome of the patients were observed.Results Compared with those in non-novel coronavirus severe pneumonia group,the levels of WBC,NEUT#,NLR,D-dimer,hs-CRP,IL-1β,IL-2 R,IL-6,IL-8,IL-10 and TNF-αwere lower in severe COVID-19 group,while LYM#,PLT and FIB were higher in severe COVID-19 group,the differences were significant(P<0.05).Compared with patients died of normal infectious severe pneumonia,the levels of NEUT#,NLR,IL-1β,IL-2 R,IL-6,IL-8 and IL-10 were lower in patients died of severe COVID-19(P<0.05),there was no significant difference on WBC,LYM#,PLT,FIB,D-dimer,hs-CRP and TNF-αbetween the death patients in the two groups(P>0.05).Conclusion The levels of inflammatory cytokines in patients with severe COVID-19 were lower than those in patients with normal infectious severe pneumonia.Monitoring the level of inflammatory factors in patients with pneumonia is helpful for clinical diagnosis and treatment.