重症肺炎患者治疗期间血清sICAM-1、IL-8动态监测对病情进展的影响

目的 分析重症肺炎患者治疗期间血清可溶性细胞间黏附分子1(sICAM-1)、白细胞介素-8(IL-8)动态监测对病情进展的影响。方法 采用前瞻性队列研究方法，选取重症肺炎患者116例为研究对象，所有患者均接受规范化治疗，根据治疗5 d内病情进展情况分为加重组(36例)及稳定组(80例),统计两组患者的一般资料、血清sICAM-1、IL-8水平及其他实验室检查结果，采用广义方程分析患者治疗1、3、5 d血清sICAM-1、IL-8动态变化情况，并采用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价血清sICAM-1、IL-8对重症肺炎患者治疗期间病情进展的预测价值。结果 治疗5 d内，116例患者中36例出现疾病进展，占31.03%。加重组治疗第1天白细胞计数、中性粒细胞计数、C反应蛋白(CRP)、降钙素原(PCT)水平均高于稳定组，差异有统计学意义(P<0.05)。经广义方程分析，与治疗第1天比较，加重组治疗第3、5天血清sICAM-1、IL-8水平均升高，稳定组治疗第3、5天血清sICAM-1、IL-8水平均降低，差异有统计学意义(P<0.05);与治疗第3天比较，...

Effect of dynamic monitoring of serum sICAM-1 and IL-8 on the progression of disease condition of severe pneumonia during treatment

Objective To analyze the effect of serum soluble intercellular adhesion molecule-1 (sICAM-1) and interleukin-8 (IL-8) dynamic monitoring on the progress of disease condition of disease condition of severe pneumonia during treatment. Methods A prospective cohort study was conducted in 116 patients with severe pneumonia. All patients received standardized treatment and were divided into progression group (36 cases) and stable group (80 cases) according to the progress of the disease within 5 days of treatment. The general data, serum sICAM-1, IL-8 level and other laboratory examination results were statistically analyzed. The dynamic changes of serum sICAM-1 and IL-8 on the 1st, 3rd and 5th day of treatment were analyzed by generalized equation. The predictive value of serum sICAM-1 and IL-8 on the progress of disease during treatment was evaluated by the receiver operating curve (ROC) and the area under the curve (AUC). Results Within 5 days of treatment, 36 of 116 patients had disease progression, accounting for 31.03%. The leukocyte count, neutrophil count, CRP and PCT in the progression group were significantly higher than those in the stable group on the first day of treatment (P<0.05). According to the generalized equation analysis, compared with 1st day of treatment, the serum sICAM-1 and IL-8 levels in the progression group were significantly increased on the 3rd and 5th day of treatment; and the serum sICAM-1 and IL-8 levels in the stable group were significantly reduced on the 3rd and 5th day of treatment (P<0.05). Compared with 3rd day of treatment, the serum sICAM-1 and IL-8 levels in the progression group were significantly increased on 5th day of treatment, and the serum sICAM-1 and IL-8 levels in the stable group were significantly reduced on the 5th day of treatment (P<0.05). The levels of serum sICAM-1 and IL-8 in the progression group were significantly higher than those in the stable group at different time points (P<0.05). The ROC curve showed that the AUC of serum sICAM-1 and IL-8, and their combined test in predicting the progress of severe pneumonia patients during treatment were 0.705, 0.701 and 0.766, respectively, which had certain predictive value, and the combined detection value was higher. Conclusion The levels of serum sICAM-1 and IL-8 in patients with severe pneumonia change with the change of the disease condition during the treatment period, which can be used as indicators to predict the progress of the disease and guide the adjustment of the treatment plan.