摘要
目的 探讨呼出气冷凝液8-iso-PG、IL-8对重症社区获得性肺炎(severe community-acquired aneumonia,SCAP)患者疾病严重程度及其预后的判断价值.方法 收集2016年1月1日-2018年8月31日重症医学科(intensive care unit,ICU)收治的SCAP患者65例,分别检测患者的C反应蛋白(CRP)、呼出气冷凝液(exhaled breath condensate,EBC)白细胞介素8(IL-8)、8-iso-PG水平,进行急性生理与慢性健康(APACHEⅡ)评分,记录氧合指数(PO2/FiO2),根据28 d转归将其中符合纳入标准的65例SCAP患者分为存活组(35人)及死亡组(30人).结果 死亡组患者CRP(t=3.051,P=0.003)、APACHEⅡ评分(t=5.176,P=0.000)、PO2/FiO2(t=4.056,P=0.000)、呼出气冷凝液8-iso-PG(t=7.986,P=0.000),IL-8(t=4.477,P=0.000)均明显高于存活组.EBC 8-iso-PG同APACHEⅡ评分(r=0.665,P=0.002)、CRP(r=0.571,P=0.000)、IL-8(r=0.762,P=0.006)呈正相关,同氧合指数呈负相关(r=-0.671,P=0.001);Logistic回归分析显示,8-iso-PG、IL-8是SCAP患者死亡的危险因素(OR=1.012和OR=1.003,P<0.05);呼出气冷凝液8-iso-PG和IL-8水平判断患者预后的ROC曲线下面积分别是0.873和0.776,其中EBC 8-iso-PG阈值是20.365 ng/mL,灵敏度为96.7%,特异度为65.7%;IL-8阈值是46.155 pg/mL,灵敏度为86.7%,特异度为57.1%.结论 呼出气冷凝液8-iso-PG、IL-8是可作为SCAP患者疾病严重程度评价指标,同时8-iso-PG和IL-8可能为SCAP潜在预后指标.
Objective To explore the value of 8-iso-pg and IL-8 in exhaled breath condensate(EBC)in judging the disease severity and prognosis of severe community acquired pneumonia(SCAP).Methods Sixty-eight patients with SCAP admitted to Intensive Care Unit(ICU)from January 1,2016 to August 31,2018 were collected.The levels of C-reactive protein(CRP),IL-8 and 8-iso-PG in EBC were measured.The acute physiology and chronic health score(APACHE II)and oxygenation index(PO2/FiO2)were recorded.On the basis of 28 day outcome,65 SCAP patients were divided into survival group(35 cases)and death group(30 cases).Results CRP(i=3.051,P=0.003),APACHE Ⅱ score(t=5.176,P=0.000),PO2/FiO2(t=4.056,P=0.000),EBC 8-iso-PG(t=7.986,P=0.000),IL-8(t=4.477,P=0.000)in the death group were significantly higher than those in the survival group(P<0.05).EBC 8-iso-PG was positively coiTelated with APACHE II score(r=0.665,P=0.002),IL-8(r=0.762,P=0.006)and CRP(r=0.571,P=0.000),negatively correlated with PO2/FiO2(r=-0.671,P=0.001).Logistic regression analysis showed that EBC IL-8 and 8-iso-PG were risk factors for SCAP mortality(OR=1.003,P<0.05 and OR=1.012,P<0.05);the areas under ROC curve of EBC 8-iso-PG and IL-8 were 0.873 and 0.776 respectively,in which 8-iso-PG threshold was 20.365 ng/mL,sensitivity is 95.6% and specificity is 87.1%;IL-8 threshold was 75.624 pg/mL,sensitivity is 96.7% and specificity is 65.7%.Conclusion EBC IL-8 and 8-iso-PG can he used as indicators of severity in SCAP,concurrently,EBC 8-iso-PG and IL-8 may be potential prognostic indicators of SCAP.
作者
陈婷
周小妹
姚莉
朱春艳
CHEN Ting;ZHOU xiaomei;YAO Li;ZHU chunyan(Department of Intensive Care Unit,The Second People's Hospital of Hefei,Hefei Anhui 230001,China)
出处
《中国急救复苏与灾害医学杂志》
2020年第6期708-711,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
安徽省公益性技术应用研究联动计划项目(15011d04060)。
