血清铁蛋白、IL-6、TNF-α表达水平与高炎症表型急性呼吸窘迫综合征患者病情严重程度及早期预后的相关性

Correlation between the expression levels of serum ferritin,IL-6,TNF-αand the severity and early prognosis of acute respiratory distress syndrome patients with high inflammatory phenotype

目的 分析血清铁蛋白(SF)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)表达水平与高炎症表型急性呼吸窘迫综合征(ARDS)患者病情严重程度及早期预后的相关性。方法 回顾性选取2020年1月至2022年12月在北京市昌平区医院就诊的高炎症表型ARDS患者124例为研究对象。根据临床诊断结果分为轻度组(n=29)、中度组(n=51)、重度组(n=44)。根据入院治疗1个月后患者情况将其分为存活组(n=83)、死亡组(n=41)。检测并比较各组SF、IL-6、TNF-α表达水平变化,并分析高炎症表型ARDS中SF、IL-6、TNF-α表达水平与病情严重程度、早期预后的相关性。结果 轻度组SF、IL-6、TNF-α表达水平分别为(127.41±13.57)μg/L、(65.24±10.04) pg/mL、(43.17±8.26) ng/mL,均低于中度组[(241.55±17.03)μg/L、(127.05±12.19) pg/mL、(71.82±9.05) ng/mL]和重度组[(378.34±20.04)μg/L、(186.73±15.25) pg/mL、(104.50±11.46) ng/mL],中度组SF、IL-6、TNF-α表达水平均低于重度组,差异均有统计学意义(P<0.05)。存活组SF、IL-6、TNF-α表达水平分别为(156.25±9.06)μg/L、(71.52±11.36) pg/mL、(51.60±7.92) ng/mL,均低于死亡组[(419.72±23.64)μg/L、(216.82±13.51) pg/mL、(161.25±12.36) ng/mL],差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,SF、IL-6、TNF-α水平表达与高炎症表型ARDS患者病情严重程度、早期预后均呈正相关(r=0.424、0.516、0.460,r=0.503、0.602、0.437;P<0.05)。结论 高炎症表型ARDS患者均伴有严重炎症反应,且SF、IL-6、TNF-α表达水平与病情严重程度、早期预后均呈正相关,需密切监测指标变化,可为病情严重程度、早期预后评估提供一定依据。

Objective To analyze the correlation between the expression levels of serum ferritin(SF),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and the severity and early prognosis of patients with high inflammatory phenotype acute respiratory distress syndrome(ARDS).Methods A total of 124 patients with high inflammatory phenotype ARDS who were treated in Changping District Hospital of Beijing from January 2020 to December 2022 were retrospectively selected as the study subjects.They were divided into mild group(n=29),moderate group(n=51),and severe group(n=44)based on clinical diagnosis.After one month of treatment,the patients were divided into survival group(n=83)and death group(n=41).The changes of SF,IL-6,and TNF-αexpression levels in all groups were tested and compare,and the correlation between the expression levels of SF,IL-6,TNF-αand the dyree of inflammatory and early prognosis in ARDS with high inflamma phenotype was analyzed.Results The expression levels of SF,IL-6,and TNF-αin the mild group were(127.41±13.57)μgL,(65.24±10.04)pg/mL,and(43.17±8.26)ng/mL,respectively,which were lower than those in the moderate group[(241.55±17.03)]μg/L,[(127.05±12.19)pg/mL,(71.82±9.05)ng/mL],severe group[(378.34±20.04)μg/L,(186.73±15.25)pg/mL,(104.50±11.46)ng/mL],the expression levels of SF,IL-6,and TNF-αin the moderate group were lower than those in the severe group,the differences were statistically significant(P<0.05).The expression levels of SF,IL-6,TNF-αin the survival group were(156.25±9.06)μg/L,(71.52±11.36)pg/mL,(51.60±7.92)ng/mL,respectively,which were lower than those of the death group[(419.72±23.64)μg/L,(216.82±13.51)pg/mL,(161.25±12.36)ng/mL],the differences were statistically significant(P<0.05).The Pearson correlation analysis results showed that the expression levels of SF,IL-6,and TNF-αwere positively correlated with the severity and early prognosis of ARDS patients with high inflammatory phenotype(r=0.424,0.516,0.460,r=0.503,0.602,0.437;P<0.05).Conclusion High inflammatory phenotype ARDS patients are accompanied by severe inflammatory reactions,and are associated with SF,IL-6,TNF-α.The expression is positively correlated with the severity of the disease and early prognosis,and it is necessary to closely monitor changes in indicators,which can provide a certain basis for evaluating the severity of the disease and early prognosis.