血清IL-6、hs-CRP、HSP70预测肝硬化并发肺部感染的价值

The value of serum IL-6, hs-CRP and HSP70 predicting liver cirrhosis complicated with pulmonary infection

目的探讨血清白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、热休克蛋白70(HSP70)预测肝硬化并发肺部感染的价值。方法选取2018年4月至2021年4月我院收治的154例肝硬化患者作为研究对象,依据是否出现肺部感染将其分为感染组(28例)与非感染组(126例),另选取同期于我院体检且身体健康的63例志愿者作为对照组。三组研究对象入院后(感染组肺部感染治疗前)均进行血清IL-6、hs-CRP、HSP70水平检测。比较三组研究对象的血清IL-6、hs-CRP、HSP70水平。分析血清IL-6、hs-CRP、HSP70单一及联合预测肝硬化并发肺部感染的价值。结果感染组的血清IL-6、hs-CRP、HSP70水平显著高于非感染组及对照组,差异具有统计学意义(P<0.05);非感染组与对照组的血清IL-6、hs-CRP、HSP70水平比较,差异无统计学意义(P>0.05)。血清IL-6、hs-CRP、HSP70均能用于肝硬化并发肺部感染的预测,曲线下面积分别为0.751、0.878、0.861,灵敏度分别为0.714、0.893、0.679,特异度分别为0.921、0.952、0.929。血清IL-6、hs-CRP、HSP70联合预测肝硬化并发肺部感染的灵敏度为96.43%(27/28),特异度为97.62%(123/126),准确率为97.40%(150/154),阳性预测值为90.00%(27/30),阴性预测值为99.19%(123/124),Kappa值为0.915。结论肝硬化并发肺部感染患者的血清IL-6、hs-CRP、HSP70水平呈异常升高趋势,联合检测可获得更高的价值,可作为肝硬化并发肺部感染的预测标志物。

Objective To investigate the value of serum interleukin-6(IL-6), hypersensitivity C-reaction protein(hs-CRP) and heat shock protein 70(HSP70) predicting liver cirrhosis complicated with pulmonary infection. Methods One hundred and fifty-four patients with liver cirrhosis treated in our hospital from April 2018 to April 2021 were selected as the research objects and divided into infection group(28 cases) and non-infection group(126 cases) according to whether had pulmonary infection, and sixty-three healthy volunteers who had physical examination in our hospital at the same period were selected as control group. The levels of serum IL-6, hs-CRP and HSP70 were detected in the three groups after admission(before treatment of pulmonary infection in the infection group). The levels of serum IL-6, hs-CRP and HSP70 were compared among the three groups. The value of serum IL-6, hs-CRP and HSP70 single and combined predicting liver cirrhosis complicated with pulmonary infection were analyzed. Results The levels of serum IL-6, hs-CRP and HSP70 in the infection group were significantly higher than those in the non-infection group and the control group,and the differences were statistically significant(P<0.05);there were no significant differences in the levels of serum IL-6,hs-CRP and HSP70 between the non-infection group and the control group(P>0.05). Serum IL-6, hs-CRP and HSP70 can be used to predict liver cirrhosis complicated with pulmonary infection, and the areas under the curve were 0.751, 0.878and 0.861 respectively;the sensitivity were 0.714, 0.893, 0.679;the specificity were 0.921, 0.952, 0.929. The sensitivity,specificity, accuracy, positive predictive value, negative predictive value of serum IL-6, hs-CRP and HSP70 combined predicting liver cirrhosis complicated with pulmonary infection were 96.43%(27/28), 97.62%(123/126), 97.40%(150/154),90.00%(27/30), 99.19%(123/124) respectively, and the Kappa value was 0.915. Conclusion The serum IL-6, hs-CRP and HSP70 levels in patients with liver cirrhosis complicated with pulmonary infection abnormally increased, and the combined detection can obtain higher value and be used as predictive markers for liver cirrhosis complicated with pulmonary infection.