摘要
目的观察动态监测重症肺炎致呼吸衰竭患儿血液CRP(C-反应蛋白)、TNF-α(肿瘤坏死因子-α)、IL-18(白细胞介素18)水平变化的临床意义。方法选取该院2015年1月—2016年1月收治的重症肺炎致呼吸衰竭患儿40例,作为观察组,同时选取同时期行健康体检儿童30例,于治疗前后应用酶联免疫吸附试验(ELISA)以及散射比浊法测定CRP及TNF-α、IL-18指标变化,并对比两组治疗前后的血气分析指标。结果观察组患儿在接受治疗前,血pH值及PO_2(7.13±0.25)(41.7±11.38)mmHg明显低于对照组的血PH值及PO_2(7.27±0.29)mmHg(55.8±8.9)mmHg,而PCO_2水平(78.5±15.6)mmHg明显高于对照组(38.9±7.6)mmHg。观察组患儿治疗后pH值及PO_2水平(7.25±0.13)(54.5±8.6)mmHg明显高于治疗前水平(7.13±0.25)(41.7±11.38)mmHg(P<0.05),PCO_2水平(37.3±8.7)mmHg显著低于治疗前(78.5±15.6)mmHg(P<0.05)且治疗前观察组CRP、TNF-α、IL-18水平(3.44±1.23)μg/L(2.21±0.62)μg/L(94.8±6.38)μg/L均明显高于对照组(1.33±1.24)μg/L(0.96±0.27)μg/L(11.32±3.16)μg/L,组间比较有显著性差异,治疗后观察组CRP、TNF-α、IL-18水平(2.88±1.09)μg/L(1.03±0.29)μg/L(58.3±10.01)μg/L均明显下降(P<0.05)。结论检测及分析CRP、TNF-α、IL-18水平变化对于了解重症肺炎合并呼吸衰竭患儿的病情及指导诊疗具有重要的临床意义。
Objective To observe the clinical significance of dynamic monitoring of blood CRP(C-reactive protein),TNF-α(tumor necrosis factor-α)and IL-18(interleukin 18)levels in children with respiratory failure caused by severe pneumonia.Methods Forty children with respiratory failure caused by severe pneumonia admitted to our hospital were selected from January 2015 to January 2016 as observation group.30 children with healthy physical examination were selected at the same time.Enzyme-linked immunosorbent assay(ELISA)and scatter nephelometry were used before and after treatment.The changes of CRP,TNF-αand IL-18 were compared,and the blood gas analysis indexes before and after treatment were compared.Results Before the treatment,the blood pH and PO2(7.13±0.25)mmHg(41.7±11.38)mmHg were significantly lower than the blood pH of the control group and PO2(7.27±0.29)mmHg(55.8±8.9)mmHg,while PCO2 level(78.5±15.6)mmHg was significantly higher than the control group(38.9±7.6)mmHg.The PH value and PO2 level(7.25±0.13)mmHg、(54.5±8.6)mmHg in the observation group were significantly higher than the pre-treatment level(7.13±0.25)mmHg、(41.7±11.38)mmHg(P<0.05)and PCO2 level(37.3±8.7)mmHg,significantly lower than before treatment(78.5±15.6)mmHg(P<0.05)and the levels of CRP,TNF-α,IL-18(3.44±1.23)μg/L(2.21±0.62)μg/L(94.8±6.38)μg/L in the observation group before treatment were significantly higher than the control group(1.33±1.24)μg/L(0.96±0.27)μg/L(11.32±3.16)μg/L had significant differences between the groups.After treatment,the levels of CRP,TNF-αand IL-18(2.88±1.09)μg/L(1.03±0.29)μg/L(58.3±10.01)μg/L all decreased significantly(P<0.05).Conclusion The detection and analysis of CRP,TNF-α,IL-18 levels have important clinical significance for understanding the condition and guiding diagnosis and treatment of children with severe pneumonia complicated with respiratory failure.
作者
王明明
陈艳萍
刘慧
WANG Ming-ming;CHEN Yan-ping;LIU Hui(Department of Clinical Laboratory,Qingdao Women and Children's Hospital,Qingdao,Shandong Province,266034 China)
出处
《系统医学》
2019年第5期36-38,共3页
Systems Medicine
