社区获得性肺炎患者血清及支气管肺泡灌洗液中IL-6、IL-8和IL-10水平变化及其临床意义
The levels of IL-6,IL-8 and IL-10 in serum and bronchoalveolar lavage fluid in patients with community-acquired pneumonia and its clinical significance
-
摘要: 目的:探讨社区获得性肺炎(CAP)患者血清和支气管肺泡灌洗液(BALF)中炎症因子白细胞介素(IL)-6、IL-8和IL-10水平的变化及其临床意义。方法:选取CAP患者50例(CAP组), 入院第1天进行临床肺部感染评分, <6分者为轻症组, ≥6分者为重症组;选取同期10名健康志愿者为对照组。双抗体夹心酶联免疫吸附法测定CAP组入院第1天以及对照组血清和BALF中IL-6、IL-8、IL-10水平, 同法测定CAP组入院第7、30天血清中IL-6、IL-8和IL-10水平。结果:CAP组入院第1天血清和BALF中IL-6、IL-8、IL-10水平均高于对照组(P<0.05~P<0.01)。CAP重症组血清中IL-6、IL-10和BALF中IL-6、IL-8 、IL-10浓度均明显高于轻症组(P<0.01)。CAP组血清IL-6和IL-10水平均随病程呈下降趋势(P<0.01), 在入院第7天和第30 天均达到对照组水平(P>0.05);而CAP组血清中IL-8水平在入院第30天仍保持较高水平, 显著高于对照组(P<0.01)。结论:IL-6、IL-8和IL-10均参与了CAP患者局部和系统的炎症反应, BALF中IL-6、IL-8、IL-10和血清中IL-6、IL-10的水平可反映肺部感染的严重程度, 检测血清中IL-6、IL-8和IL-10对CAP早期诊断有一定的临床价值。Abstract: Objective:To explore the levels of IL-6, IL-8 and IL-10 in serum and bronchoalveolar lavage fluid(BALF) of patients with community-acquired pneumonia(CAP), and its clinical significance.Methods:The clinical pulmonary infection score of 50 patients with CAP were detected on the first day after admission.The patients with CPIS less than 6 and equal to or more than 6 were divided into the light group and severe group, respectively.Ten healthy people were set as the control group.The levels of IL-6, IL-8 and IL-10 in serum and BALF of the patients with CAP were determined by radioimmunoassay on the first day after admission.The levels of IL-6, IL-8 and IL-10 in serum of the patients with CAP were also measured on day 7 and 30 of admission.Results:The levels of IL-6, IL-8 and IL-10 in serum and BALF of CAP patients were significantly higher than those in control group on the first day after admission(P<0.05 to P<0.01).The levels of IL-6 and IL-10 in serum and levels of IL-6, IL-8, IL-10 in BALF in severe CAP group were significantly higher in light CAP patients(P<0.01).With the disease course prolonging, the levels of IL-6 and IL-10 decreased(P<0.01), which arrived at the level of the control group on day 7 and 30 of admission(P>0.05).The level of IL-8 in serum of CAP patients remained at a high level on day 30 of admission, which was significantly higher than that in control group(P<0.01).Conclusions:The IL-6, IL-8 and IL-10 were involved in the pathogenesis of community-acquired pneumonia.The levels of IL-6 and IL-10 in serum and levels of IL-6, IL-8 and IL-10 in BALF can reflect the severity of pulmonary infection.The detection of IL-6, IL-8 and IL-10 in serum has certain clinical value in the early diagnosis of CAP.
-
Key words:
- pneumonia /
- bronchoalveolar lavage fluid /
- interleukin
-
[1] 中华医学会呼吸病学会分会.社区获得性肺炎诊断和治疗指南[J].中华结核和呼吸杂志, 2006,54(10):651-655. [2] Moret I,Lorenzo MJ,Sarria B,et al.Increased lung neutrophil apoptosis and inflammation resolution in nonresponding pneumonia[J].Eur Respir,2011,38(5):1158-1164. [3] 乔红梅, 庞焕香, 张云峰, 等.肺炎支原体肺炎患儿IL-6、IL-10、TNF-α 的变化[J].临床儿科杂志,2012,30(1):59-61. [4] 姚娜, 李树德, 王文林.IL-6、IL-10在实验性肺部炎症中的研究进展[J].昆明医科大学学报,2014,35(3):161-163. [5] Lee YL,Chen W,Chen LY,et al.Systemic and bronchoalveolar cytokines as predictors of in-hospital mortality in severe community-acquired pneumonia[J].J Crit Care,2010,25(1):176.e7-e13. [6] Paats MS,Bergen IM,Hanselaar WE,et al.Local and systemic cytokine profiles in nonsevere and severe community-acquired pneumonia[J].Eur Respir,2013,41(6):1378-1385. [7] Pugin J,Auckenthaler R,Mill N,et al.Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic "blind" bronchoalveolar lavage fluid [J].Am Rev Respir Dis,1991,143(5 Pt 1):1121-1129. [8] 郭晋, 伍德生, 吴晓飞.依达拉奉对百草枯中毒肺损伤患者血清IL-6 和TNF-α 的影响[J].蚌埠医学院学报,2013,38(8):939-943. [9] 李寿军, 张云, 武能舜, 等.小儿支原体肺炎IL-6,、IL-8、TNF-检测及其与病情严重程度的关系[J].南昌大学学报:医学版,2012,52(8):35-37. [10] Rodriguez N,Dietrich H,Mossbrugger I,et al.Increased inflammation and impaired resistance to Chlamydophila pneumoniae infection in Dusp1(-/-) mice:critical role of IL-6[J].J Leukoc Biol,2010,88(3):579-587. [11] 曾杰, 陈宁波.白介素6 、白介素8和白介素10及肿瘤坏死因子在重症急性胰腺炎中的表达及与预后的相关性研究[J].实用心脑肺血管杂志,2013,21(6):28-31. [12] Wu CL,Chan MC,Chang GC,et al.Etiology and cytokine expression in patients requiring mechanical ventilation due to severe community-acquired pneumonia[J].Formos Med Assoc,2006,105(1):49-55. [13] Fernandez-Serrano S,Dorca J,Coromines M,et al.Molecular inflammatory responses measured in blood of patients with severe community-acquired pneumonia[J].Clin Diagn Lab Immunol,2003,10(5):813-820. [14] Antunes G,Evans SA,Lordan JL,et al.Systemic cytokine levels in community-acquired pneumonia and their association with disease severity[J].Eur Respir,2002,20(4):990-995. [15] Endeman H,Meijvis SC,Rijkers GT,et al.Systemic cytokine response in patients with community-acquired pneumonia [J].Eur Respir 2011,37(6):1431-1438. -
点击查看大图
计量
- 文章访问数: 3794
- HTML全文浏览量: 463
- PDF下载量: 142
- 被引次数: 0
下载:
