重症肺炎患者肺泡灌洗液的炎症因子动态变化特点及临床意义

目的动态检测重症肺炎患者支气管肺泡灌洗液的促炎因子IL-6和抑炎因子IL-10治疗前后表达水平的变化,阐明其变化情况与肺炎严重程度及预后的相关性。方法采用ELISA方法检测20例重症肺炎患者治疗第1天及第7天IL-6和IL-10表达水平,同时观察重症肺炎严重程度和转归、预后。结果重症肺炎支气管肺泡灌洗液IL-6表达水平显著高于普通肺炎组及正常组,重症肺炎支气管肺泡灌洗液IL-10表达水平明显高于正常组,但是与普通肺炎组水平无明显差异,治疗7天后IL-6表达水平下降,但是好转组与恶化组水平无差异,好转组IL-10水平下降至正常,但是恶化组IL-10水平明显上升。结论说明重症肺炎局部炎症水平较普通肺炎高,支气管肺泡灌洗液IL-6水平与肺炎严重程度相关,支气管肺泡灌洗液IL-10水平与重症肺炎预后相关。

Clinical significance of dynamic detection of inflammatory cytokine in bronchial alveolar lavage of patients with severe pneumonia

Objective To observe the the expression of IL-6 and IL-10 before and after therapy in bronchial alveolar lavage of patients with severe pneumonia, and to clarify the relationship between the severity of pneumonia and prognosis. Methods ELISA method was used to detect the expression of IL-6 and IL-10 in bronchial alveolar lavage of 20 patients with severe pneumonia before and 1 week after the treatment, and the severity, outcome and prognosis were observed. Results The expression of IL-6 in bronchial alveolar lavage of the severe pneumonia group was significant higher than that in the ordinary pneumonia group and the normal group, and the expression of IL-10 in bronchial alveolar lavage of the severe pneumonia group was significant higher than that in the normal group. 7 days after the treatment, the expression of IL-6 decreased, but there was no significant difference between the improved group and the depravation group. The expression of IL-10 in the improved group decreased to the normal level, but it increased in the depravation group. Conclusion The local inflammation level of severe pneumonia is severer than ordinary pneumonia. The expression of IL-6 in bronchial alveolar lavage is associated with the severity of pneumonia, and the expression of IL-10 is associated with the prognosis of pneumonia.