炎症因子在老年重症肺部感染患者病情及预后评估中的应用研究

Application of inflammatory factors in the assessment of disease condition and prognosis in elderly patients with severe pulmonary infection

目的 探讨炎症因子对老年重症肺部感染患者病情及预后评估的临床应用价值。方法 以我院2018年5月—2022年4月收治的80例老年重症肺部感染患者为观察组,以同期80例老年轻症肺部感染患者为对照组;使用ELISA方法检测两组炎症因子水平,并评估两组肺部感染评分(CPIS);两组均治疗28 d后,分析炎症因子水平与患者病情、CPIS评分及预后的关系。结果 观察组IL-6(93.28±22.15)pg/mL、IL-8(552.14±184.32)pg/mL、PCT(6.32±2.28)mg/L及TNF-α(208.36±11.42)pg/mL均明显高于对照组[(21.36±7.36)pg/mL、(210.23±145.67)pg/mL、(0.93±0.17)mg/L、(103.28±16.62)pg/mL](P<0.05)。观察组治疗1 d时,IL-6(90.15±20.06)pg/mL、IL-8(549.36±180.21)pg/mL、PCT(6.32±2.28)mg/L、TNF-α(198.24±10.08)pg/mL明显高于治疗3 d[(79.26±18.42)pg/mL、(318.25±190.31)pg/mL、(5.42±1.86)mg/L、(178.14±16.05)pg/mL]和治疗7 d时[(63.12±10.28)pg/mL、(225.26±150.41)pg/mL、(3.23±0.32)mg/L、(135.27±20.06)pg/mL](P<0.05)。观察组CPIS评分与IL-6(r=0.704,P=0.002)、IL-8(r=0.735,P=0.000)、PCT(r=0.741,P=0.000)、TNF-α(r=0.693,P=0.003)均呈正相关。死亡组IL-6(78.28±20.36)pg/mL、IL-8(472.42±121.36)pg/mL、PCT(4.42±1.86)mg/L及TNF-α(182.23±9.86)pg/mL均明显高于存活组[(24.52±8.24)pg/mL、(248.54±112.65)pg/mL、(1.23±0.122)mg/L、(115.14±12.01)pg/mL](P<0.05)。结论 炎症因子与老年重症肺部感染病情严重程度及患者预后有关,是导致患者死亡的重要原因之一。

Objective To investigate the clinical application value of inflammatory factors in evaluating the condition and prognosis of elderly patients with severe pulmonary infection.Methods From May 2018 to April 2022,80 elderly patients with severe pulmonary infections in our hospital were selected as the observation group,while 80 elderly patients with mild pulmonary infections in the same period were selected as the control group.The levels of inflammatory factors in two groups were detected using ELISA method and The pulmonary infection score(CPIS)of both groups were evaluated;After 28 days of treatment in both groups,the relationship between inflammatory factor levels and patient condition,CPIS score,and prognosis were analyzed.Results IL-6(93.28±22.15)pg/mL,IL-8(552.14±184.32)pg/mL,PCT(6.32±2.28)mg/L and TNF-α(208.36±11.42)pg/mL in observation group were significantly higher than those in the control group[(21.36±7.36)pg/mL,(210.23±145.67)pg/mL,(0.93±0.17)mg/L,(103.28±16.62)pg/mL](P<0.05).After 1 day of treatment in the observation group,IL-6(90.15±20.06)pg/mL,IL-8(549.36±180.21)pg/mL,PCT(6.32±2.28)mg/L,TNF-α(198.24±10.08)pg/mL were significantly higher than those 3 days after treatment[(79.26±18.42)pg/mL,(318.25±190.31)pg/mL,(5.42±1.86)mg/L,(178.14±16.05)pg/mL and 7 days after treatment[(63.12±10.28)pg/mL,(225.26±150.41)pg/mL,(3.23±0.32)mg/L,(135.27±20.06)pg/mL](P<0.05).In the observation group,CPIS score was positively correlated with IL-6(r=0.704,P=0.002),IL-8(r=0.735,P=0.000),PCT(r=0.741,P=0.000),and TNF-α(r=0.693,P=0.003).IL-6(78.28±20.36)pg/mL,IL-8(472.42±121.36)pg/mL,PCT(4.42±1.86)mg/L and TNF-α(182.23±9.86)pg/mL in death group were significantly higher than those in the survival group[(24.52±8.24)pg/mL,(248.54±112.65)pg/mL,(1.23±0.122)mg/L,(115.14±12.01)pg/mL](P<0.05).Conclusion Inflammatory factors are related to the severity and prognosis of elderly patients with severe pulmonary infection,which is one of the important causes of death.