重症肺炎患者下呼吸道内sTREM-1、TNF-α及IL-10水平的变化

目的探讨重症肺炎患者下呼吸道内sTREM-1、TNF-α及IL-10水平的变化及其临床意义。方法研究组纳入60例重症肺炎患者,对照组纳入30例健康者,研究组分为存活组和死亡组,对比研究组和对照组以及存活组和死亡组诱导痰sTREM-1及TNF-α、IL-10水平的变化。结果研究组下呼吸道诱导痰中sTREM-1、TNF-α及IL-10水平及TNF-α/IL-10显著高于对照组(P<0.01)。气管插管后各时段,两组诱导痰sTREM-1水平动态变化差异均有统计学意义(P<0.05),死亡组在气管插管1d后各时段诱导痰sTREM-1水平均显著高于存活组(P<0.05)。气管插管后5个时段,两组诱导痰TNF-α、IL-10水平动态变化差异均有统计学意义(P<0.05),死亡组在气管插管后5个时段诱导痰TNF-α、IL-10水平均显著高于存活组(P<0.01)。气管插管后两组诱导痰TNF-α/IL-1无显著改变(P>0.05),死亡组在后3个时段诱导痰TNF-α/IL-1均显著高于存活组(P<0.05)。结论 sTREM-1于重症肺炎患者气道内高表达,对局部炎症的过反应有促进作用,死亡患者表现尤为明显。

Changes of sTREM-1, TNF-alpha and IL-10 levels in lower respiratory tract of patients with severe pneumonia

Objective To explore the lower respiratory tract in patients with severe pneumonia of sTREM-1, TNF-alpha and IL-10 levels in its clinical significance. Methods The study group included 60 cases of patients with severe pneumo- nia, the control group included 30 cases of healthy subjects, the study group was divided into the survival group and death group, comparative study and control groups and the survival group and death group induced to talk of sTREM-1 and TNF—α IL-10 levels change. Results The respiratory tract induced sputum of sTREM-1, TNF—α and IL-10 levels and TNF-alpha/IL-10 in the study group was significantly higher than the control group （P 〈 0.01）. After tracheal intubation, each period, two sets of dynamic difference in induced sputum of sTREM-1 levels were statistically significant （P 〈 0.05）, the group of death in the period the day after the tracheal intubation induced sputum of sTREM-1 water were significantly higher than survival group （P 〈 0.05）. Five periods after intubation, two groups of induced sputum TNF-alpha, IL-10 level dynamic change differences were statistically significant （P 〈 0.05）, death group after intubation five periods of induced sputum TNF-alpha, IL-10 levels were significantly higher than the survival group （P 〈 0.01）. The two groups after tracheal intubation induced sputum TNF-alpha/IL-1 had no significant change （P 〉 0.05）, death group after three hours of induced sputum TNF-alpha/IL-1 were significantly higher than the survival group （P 〈 0.05 ）. Conclusion Of sTREM-1 in the airways of severe pneumonia in patients with high expression over response to local inflammation, particularly of patients who died.