重症肺炎伴Ⅱ型呼吸衰竭患者血清PCT、IL-6与患者器官衰竭的相关性及对预后的预测价值

Correlation of Serum PCT,IL-6 and Organ Failure in Patients with Severe Pneumonia and TypeⅡRespiratory Failure and the Prognostic Value

目的探究重症肺炎伴Ⅱ型呼吸衰竭患者血清降钙素原(PCT)、白细胞介素-6(IL-6)与患者器官衰竭的相关性及对预后的预测价值。方法选取2022年2月至2023年2月厦门市第五医院诊治的98例重症肺炎伴Ⅱ型呼吸衰竭患者,根据1个月后恢复情况分为预后良好组(68例)、预后不良组(30例)。比较两组治疗前、治疗7 d后血清PCT、IL-6水平及急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分、多器官功能障碍(MODS)评分,采用Pearson分析相关性,采用受试者工作特征曲线(ROC)分析预后预测价值。结果预后良好组治疗前、治疗7 d后血清PCT、IL-6低于预后不良组(P<0.05);预后良好组治疗前、治疗7 d后血清APACHEⅡ评分、MODS评分低于预后不良组(P<0.05);治疗前血清PCT、IL-6水平与APACHEⅡ评分、MODS评分呈正相关(P<0.05);治疗7 d后血清PCT、IL-6联合预测的重症肺炎伴Ⅱ型呼吸衰竭患者预后良好AUC为0.920,大于各单一指标检测(P<0.05)。结论重症肺炎伴Ⅱ型呼吸衰竭患者治疗前血清PCT、IL-6水平与APACHEⅡ评分、MODS评分密切相关,故可作为临床判断器官衰竭程度、评估预后转归情况的辅助指标。

Objective To investigate the correlation of serum procalcitonin(PCT)and interleukin-6(IL-6)with organ failure in patients with severe pneumonia and typeⅡrespiratory failure,and the predictive value of prognosis.Methods A total of 98 cases of severe pneumonia with typeⅡrespiratory failure diagnosed and treated in our hospital from February 2022 to February 2023 were divided into good prognosis group(n=68)and poor prognosis group(n=30)according to the recovery condition one month later.Serum PCT and IL-6 levels,Acute physiological and chronic Health ScoreⅡ(APACHEⅡ)score and multiple organ dysfunction(MODS)score were compared between the two groups before treatment and 7 days after treatment.Pearson analysis was used to analyze the correlation,and receiver operating characteristic curve(ROC)was used to analyze the prognostic value.Results Serum PCT and IL-6 in the good prognosis group were lower than those in the poor prognosis group before and 7 days after treatment(P<0.05).Serum APACHEⅡscores and MODS scores of the good prognosis group were lower than those of the poor prognosis group before and after 7 days of treatment(P<0.05).Serum PCT and IL-6 levels were positively correlated with APACHEⅡscore and MODS score before treatment(P<0.05).After 7 days of treatment,the AUC of severe pneumonia with typeⅡrespiratory failure predicted by serum PCT and IL-6 combined was 0.920,which was higher than that of each single index(P<0.05).Conclusions Serum PCT and IL-6 levels in patients with severe pneumonia and typeⅡrespiratory failure before treatment are closely related to APACHEⅡscore and MODS score,so they can be used as auxiliary indicators to judge the degree of organ failure and evaluate the prognosis.