摘要
目的探讨老年细菌性下呼吸道感染患者血清炎性因子表达水平及临床意义。方法收集2019年9月至2020年1月因下呼吸道感染住院的老年患者75例,其中细菌培养阳性患者55例作为细菌感染组,病毒检测阳性患者20例为病毒感染组,随机选取同期进行体检的正常个体30例作为正常对照组。检测3组外周血细胞因子(IL-2、TNF-α、IFN-γ、IL-4、IL-6、IL-10及IL-17)、PCT、CRP、SAA和WBC等指标表达差异,并分析其临床意义。结果细菌感染组的IL-2、IL-4、IL-6、IL-10、PCT、CRP、SAA和WBC的表达水平明显高于病毒感染组与正常对照组(P<0.05);IL-6与SAA联合检测用于鉴别细菌性与病毒性下呼吸道感染的灵敏度和特异性分别为96.2%与93.9%,优于单独检测各指标。结论老年细菌性下呼吸道感染患者血清细胞因子、PCT、CRP、SAA和WBC等指标水平变化显著,可作为诊断其敏感指标。且IL-6与SAA两指标联合、动态监测有助于评估患者的免疫功能状态及患者的感染程度并指导治疗,具有重要的临床意义。
Objective To investigate the expression levels and clinical significance of inflammatory mediators in elderly patients with bacterial lower respiratory tract infection.Methods A total of 75 elderly patients with lower respiratory tract infection who were admitted and treated in our hospital from September 2019 to January 2020 were enrolled in the study,of whom,55 patients with positive bacterial culture were enrolled as bacterial infection group,and 20 patients with positive virus detection were enrolled as virus infection group,moreover,the other 30 subjects who underwent physical examination at the same period were enrolled as control group.The expression levels of peripheral blood cytokines including IL-2,TNF-α,IFN-γ,IL-4,IL-6,IL-10 and IL-17,and PCT,CRP,SAA and WBC were detected and compared among the three groups.In addition the clinical significance of these indexes was analyzed.Results The expression levels of IL-2,IL-4,IL-6,IL-10,PCT,CRP,SAA and WBC in bacterial infection group were significantly higher than those in virus infection group and control group(P<0.05).The sensitivity and specificity of the combination detection of IL-6 with SAA for the identification of bacterial or viral lower respiratory tract infections were 96.2%and 93.9%,respectively,which were superior to those by simple index detection.Conclusion The serum cytokines including PCT,CRP,SAA and SAA WBC in elderly patients with bacterial lower respiratory tract infection have significant changes,which can be regarded as the sensitive indexes for diagnosis.And the combination detection of IL-6 and SAA and dynamic monitoring are helpful to assess the immune function status and infection degree of patients so as to guide the treatment,which is of important clinical significance.
作者
李立新
潘婧
齐菊菊
梁芸
李玉雪
宋国威
万玲玲
LI Lixin;PAN Jing;QI Jvjv(Department of Clinical Laboratory,The First Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050031,China)
出处
《河北医药》
CAS
2020年第20期3085-3088,3093,共5页
Hebei Medical Journal
基金
石家庄市科学技术研究与发展计划(编号:171462093)。
关键词
老年
细菌性下呼吸道感染
细胞因子
炎性因子
流式细胞术
the elderly
lower respiratory tract infection caused by bacteria
cytokines
inflammatory factors
flow cytometry
