老年重症肺炎患者血清中炎症细胞因子及髓样分化因子88水平与预后的关系

The relationship between serum levels of inflammatory cytokines and myeloid differentiation factor 88 and prognosis in elderly patients with severe pneumonia

目的探讨老年重症肺炎患者血清中炎症细胞因子、髓样分化因子88(myeloid differentiation factor 88,MyD88)水平与预后的关系。方法选择2018年5月~2021年4月在某院ICU诊治的老年重症肺炎患者68例作为肺炎组,选择同期老年健康体检者68例为健康组,检测两组血清白细胞介素(Interleukin,IL)-1β、IL-8、MyD88水平,调查患者的急性生理学和慢性健康状况Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、预后并进行相关性分析。结果肺炎组的血清IL-1β、IL-8、MyD88水平都高于健康组(P<0.05)。在肺炎组中,APACHEⅡ评分为(24.51±1.58)分,Pearson相关分析显示APACHEⅡ评分与IL-1β、IL-8、MyD88相关(P<0.05)。Logistic回归分析显示IL-1β、IL-8、MyD88为导致患者预后不良的危险因素(P<0.05)。ROC曲线分析显示IL-1β、IL-8、MyD88水平预测患者预后不良的曲线下面积(area under curve,AUC)分别为0.695、0.758、0.828。结论老年重症肺炎患者伴随有血清IL-1β、IL-8、MyD88水平上调,三者都可能参与老年重症肺炎的发生发展过程,对预测患者预后也具有重要的价值。

Objective To investigate the relationship between serum levels of inflammatory cytokines and myeloid differentiation factor 88(MyD88)and prognosis in elderly patients with severe pneumonia.Methods From May 2018 to April 2021,68 cases of elderly patients with severe pneumonia diagnosed and treated in the ICU of our hospital were selected as the pneumonia group,and 68 cases of elderly healthy physical examination patients during the same period were selected as the healthy group.The serum interleukin(IL)-1β,IL-8,MyD88 of the two groups were tested,and the patients'acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores were investigated,then the relationship between serum levels of inflammatory cytokines and myeloid differentiation factor 88 and prognosis in elderly patients with severe pneumonia were be figured out.Results The levels of serum IL-1β,IL-8,MyD88 in the pneumonia group were higher than those in the healthy group(P<0.05).In the pneumonia group,the APACHEⅡscore were(24.51±1.58)points,and Pearson correlation analysis showed that APACHEⅡscore was correlation with IL-1β,IL-8,MyD88 related(P<0.05).Logistic regression analysis showed that IL-1β,IL-8,MyD88 were risk factors leaded to poor prognosis of patients(P<0.05).ROC curve analysis showed that the area under curve(AUC)of IL-1β,IL-8,MyD88 levels predicting poor prognosis of patients were 0.695,0.758,0.828,respectively.Conclusion Elderly patients with severe pneumonia are accompanied by up-regulation of serum IL-1β,IL-8,MyD88 levels.IL-1β,IL-8,MyD88 may be involved in the occurrence and development of elderly severe pneumonia,which were important for predicting the prognosis of patients.