病毒性肺炎患者血清IL-6和MCP-1水平检测的临床意义

Clinical significance of serum IL-6 and MCP-1 levels in patients with viral pneumonia

目的通过对病毒性肺炎患者血清标本中的趋化因子和细胞因子进行综合分析,以寻找与疾病进展有关的候选生物标志物。方法对2019年5月至2020年3月入院的120例年龄≥18岁的病毒性肺炎患者进行回顾性队列研究,分为轻/中度组和重度/危重组。收集入院时的血清标本,采用酶联免疫吸附试验检测血清λ3干扰素(IFN-λ3)、白细胞介素6(IL-6)、干扰素诱导蛋白10(IP-10)、CX3C型趋化因子配体17(CCL17)和单核细胞趋化蛋白1(MCP-1)水平。比较两组各项血清细胞因子和趋化因子水平。采用二元Logistic回归和受试者工作特征(ROC)曲线分析血清细胞因子和趋化因子与病毒性肺炎进展为重度/危重的关系。结果重度/危重组入院时血清CCL17水平低于轻/中度组,而入院时血清IFN-λ3、IL-6、IP-10和MCP-1水平高于轻/中度组,差异有统计学意义(P<0.05)。二元Logistic回归分析发现,入院时血清IL-6和MCP-1水平升高是疾病进展的独立预测因子(P<0.05)。经ROC分析,入院时血清IL-6、MCP-1联合肺炎严重指数(PSI)评分预测病毒性肺炎进展为重度/危重的曲线下面积大于PSI评分单独预测的AUC(Z=-3.795,P=0.037)。结论IL-6、MCP-1可能是用于区分轻/中度和重度/危重病毒性肺炎患者的有效标志物。

Objective A comprehensive analysis of chemokines and cytokines in serum samples from patients with viral pneumonia was conducted to identify candidate biomarkers associated with disease progression.Methods A retrospective cohort study was conducted among 120 patients with respiratory virus infection who were hospitalized from May 2019 to March 2020 and divided into mild/moderate group and severe/critical group.Serum samples were collected at admission.Serum levels ofλ3-interferon(IFN-λ3),interleukin 6(IL-6),interferon-induced protein 10(IP-10),CX3 C chemokine ligand 17(CCL17)and monocyte chemoattractant protein 1(MCP-1)were measured by enzyme-linked immunosorbent assay.The levels of serum chemkines and cytokines in the two groups were compared.Binary Logistic regression and receiver operating characteristic(ROC)curve was used to analyze the relationships between serum cytokines,chemokines and the risk of severe/critical viral pneumonia.Results The serum levels of CCL17 in severe/critical group at admission were lower than those in mild/moderate group,while serum levels of IFN-λ3,IL-6,IP-10 and MCP-1 at admission were higher than those in mild/moderate group(P<0.05).Binary Logistic regression analysis showed that serum IL-6 and MCP-1 increased at admission were independent predictors of disease progression(P<0.05).The area under the curve predicted by combined detection of serum IL-6,MCP-1 at admission and pneumonia severity index(PSI)score for the severe/critical patients was better than that predicted by PSI score alone(Z=-3.795,P=0.037).Conclusion IL-6 and MCP-1 might be useful prognostic markers for differentiating mild/moderate from severe/critical patients.