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目的探讨肺炎患者血液中白介素6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)浓度与肺炎患者病情严重程度的关联性。方法选取2013年1月至2014年7月收治的符合纳入标准的肺炎患者100例,按病情严重程度分为肺炎组50例和重症肺炎50例。于入院当日记录每例患者的基本资料,评价APACHEⅡ评分,抽取静脉血液8 ml分别测定血液中IL-6、CRP、PCT浓度。肺炎病情严重程度与炎性因子IL-6、CRP、PCT浓度之间的关系采用多元Logistic回归分析。结果单因素分析结果显示:年龄、性别、体温、D-二聚体、Pa CO2、血糖等指标水平与肺炎的严重程度无关(P均>0.05),而白细胞计数、APACHEⅡ评分、死亡风险系数、呼吸频率、心率、IL-6、PCT、CRP水平与肺炎严重程度有关联(P均﹤0.05)。将与肺炎病情严重程度有关联的IL-6、PCT、CRP、白细胞计数、APACHEⅡ评分等指标赋值后纳入Logistic回归模型,IL-6、CRP、白细胞计数等指标水平与肺炎严重程度无关(P均>0.05),而APACHEⅡ评分、PCT水平为肺炎严重程度的独立影响因素(P均﹤0.05);OR值显示,重症肺炎组PCT浓度为肺炎组的0.984倍,重症肺炎组APACHEⅡ评分为肺炎组的1.253倍。结论炎性因子PCT浓度、APACHⅡ评分对肺炎患者、特别是重症肺炎患者病情严重程度评估有一定指导价值。
Objective To investigate the correlation between the levels of interleukin 6 (IL-6), C-reactive protein (CRP) and procalcitonin (PCT) in patients with pneumonia and the severity of pneumonia. Methods 100 patients with pneumonia who met the inclusion criteria from January 2013 to July 2014 were divided into pneumonia group (50 cases) and severe pneumonia (50 cases) according to the severity of the disease. On the day of admission, the basic data of each patient were recorded, APACHEⅡscore was evaluated, 8 ml venous blood was drawn for determination of IL-6, CRP and PCT concentrations in the blood. The relationship between severity of pneumonia and inflammatory cytokines IL-6, CRP and PCT concentrations was analyzed by multivariate Logistic regression. Results The results of univariate analysis showed that the levels of age, sex, body temperature, D-dimer, PaCO 2 and blood glucose were not related to the severity of pneumonia (P all> 0.05), while the white blood cell count, APACHEⅡscore, Respiratory rate, heart rate, IL-6, PCT and CRP levels were correlated with the severity of pneumonia (all P <0.05). The levels of IL-6, PCT, CRP, WBC and APACHEⅡ were correlated with the severity of pneumonia. Logistic regression model was used to evaluate the severity of pneumonia. The levels of IL-6, CRP and leukocyte count were not related to the severity of pneumonia > 0.05). The APACHEⅡscore and PCT level were independent influencing factors of severity of pneumonia (P <0.05). OR value showed that PCT concentration in severe pneumonia group was 0.984 times of pneumonia group, APACHEⅡscore group in severe pneumonia group was pneumonia group 1.253 times. Conclusions The PCT of inflammatory cytokines and APACHⅡ score have some guiding value in the evaluation of the severity of pneumonia patients, especially severe pneumonia patients.