血清hs-CRP、IL-6、PCT对新型冠状病毒肺炎患者的诊断及预后评估的临床意义

目的探讨检测超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、降钙素原(PCT)对新型冠状病毒肺炎(COVID-19)患者预后评估的临床价值。方法选择150例COVID-19患者按诊断标准分为4组:轻型组(48例)、普通型组(45例)、重型组(35例)、危重型组(22例),测定各组患者血清hs-CRP、IL-6、PCT水平,并分析血清hs-CRP、IL-6、PCT水平对COVID-19患者预后评估以及对死亡风险的预测。结果对于血清hs-CRP、IL-6、PCT水平,危重型组>重型组>普通型组>轻型组,差异均有统计学意义(P<0.05)。随着患者病情的加重,APACHEII评分也逐渐升高,但差异无统计学意义。血清hs-CRP、IL-6、PCT三者联合检测对患者预后的判断强于单一项目。与存活组比较,死亡组的hs-CRP、IL-6、PCT明显升高,两组比较差异具有统计学意义(P<0.05)。血清hs-CRP、IL-6、PCT水平联合检测在预测COVID-19死亡风险的准确率大于单一项目(P<0.05),与APACHE II评分相差不大。结论血清hs-CRP、IL-6、PCT联合检测有助于判断COVID-19患者的预后,并且可以用来评估COVID-19患者的死亡风险。

Clinical significance of serum hs-CRP, IL-6, and PCT in diagnosis and prognosis of patients with COVID-19

Objective To investigate the effect of apigenin on insulin resistance in gestational diabetes mellitus (GDM) rats, and to explore the possible mechanism. Methods On the 5th day of pregnancy, GDM model rats were prepared by tail iv 35 mg/kg streptozotocin suspension, GDM model rats were randomly divided into model group, apigenin low, medium and high dose (10, 20 and 40 mg/kg) group and metformin group (positive control, 20 mg/kg). Normal pregnant rats were set as control group, with 12 rats in each group. The levels of fasting blood glucose (FBG), insulin (FINS), insulin resistance index (HOMA-IR) and serum triglyceride (TG), total cholesterol (TC) and high density lipoprotein (HDL-C) were measured by automatic biochemical method, the level of malondialdehyde (MDA) was measured by thiobarbituric acid method, superoxide dismutase (SOD) was detected by azoblue tetrazole colorimetry, histopathological changes of islets were observed by HE staining, semi-quantitative scoring was used to evaluate islet tissue injury, and the expressions of phosphatidylinositol 3 kinase (PI3K), p-PI3K, protein kinase B (Akt) and p-Akt in islet tissues were detected by Western blotting. Results Compared with control group, FBG, FINS and HOMA-IR increased in GDM group, TC, TG and HDL-C increased, the level of SOD decreased, the level of MDA increased, the histopathological score of islets increased, and the phosphorylation levels of PI3K and Akt proteins in islet tissue decreased (P < 0.05). Compared with GDM group, FBG, FINS and HOMA-IR decreased in Apigenin low, medium and high dose groups and Metformin group, TC, TG and HDL-C decreased, the level of SOD increased, the level of MDA decreased, the histopathological score of islets decreased, and the phosphorylation levels of PI3K and Akt proteins in islet tissue increased (P < 0.05). Conclusions Apigenin can improve blood glucose and blood lipid, reduce insulin resistance and protect islet tissue. Its mechanism may be related to activation of PI3K /Akt signal pathway.