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目的探讨血清肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)及乳酸水平与重症肺炎转归的关系。方法将136例重症肺炎患者按临床转归分为2组:良好组(63例)和不良好组(73例)。检测2组血清TNF-α、IL-10及乳酸的水平。分析血清TNF-α、IL-10及乳酸水平与重症肺炎良好组的相关性。结果与不良好组比较,良好组血清TNF-α、乳酸水平均明显降低,血清IL-10水平明显升高(均P<0.05)。血清TNF-α、乳酸水平与重症肺炎良好组均呈正相关(r=0.694、0.608,均P<0.05),血清IL-10水平与重症肺炎良好组呈负相关(r=-0.728,P<0.05)。结论动态监测血清中TNF-α、IL-10及乳酸水平有助于判断重症肺炎的病情程度和预后,值得临床应用。
Objective To investigate the relationship between serum levels of tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) and lactic acid in patients with severe pneumonia. Methods One hundred and sixty-six patients with severe pneumonia were divided into two groups according to clinical outcome: the good group (63 cases) and the bad group (73 cases). Serum levels of TNF-α, IL-10 and lactate were measured in two groups. The correlations of serum TNF-α, IL-10 and lactate levels with severe pneumonia were analyzed. Results Compared with the poor group, serum TNF-α and lactate levels were significantly decreased and serum IL-10 levels were significantly increased in the good group (all P <0.05). Serum levels of TNF-α and lactate were positively correlated with those with severe pneumonia (r = 0.694,0.608, all P <0.05), and serum IL-10 levels were negatively correlated with those with severe pneumonia (r = -0.728, P <0.05 ). Conclusion Dynamic monitoring of serum TNF-α, IL-10 and lactate levels can help determine the severity and prognosis of severe pneumonia, which deserves clinical application.