血清磷脂酶A2、降钙素原和白细胞介素6、10因子对重症肺炎患者预后的预测价值

doi:10.20047/j.issn1673-7210.2023.08.27

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摘要目的分析血清磷脂酶A2（PLA2）、降钙素原（PCT）和白细胞介素（IL）-6和IL-10因子对重症肺炎患者预后的预测价值。方法选择2021年10月至2022年5月安徽省安庆市立医院收治的160例重症肺炎患者。治疗前检测患者血清PLA2、PCT、IL-6、IL-10水平，根据患者入院28 d内预后情况分成预后不良组与预后良好组，分析重症肺炎患者预后不良的危险因素，分析血清PLA2、PCT、IL-6、IL-10水平及四者联合预测重症肺炎患者预后不良的价值。结果 160例患者入院28 d内预后不良44例，预后不良率为27.50%，预后良好116例。预后不良组有创机械通气总时间、肺炎严重程度评分、血清PLA2、PCT、IL-6、IL-10水平及序贯器官衰竭（SOFA）评分均高于预后良好组（P＜0.05）。血清PLA2升高、PCT升高、IL-6升高、IL-10升高及SOFA评分升高为重症肺炎患者预后不良的危险因素（P＜0.05）。血清PLA2、PCT、IL-6、IL-10水平及四者联合预测重症肺炎患者预后不良的曲线下面积（AUC）值分别为0.729、0.726、0.738、0.704、0.832，且四者联合预测的AUC值均高于单独检测（P＜0.05）。结论血清PLA2、PCT、IL-6、IL-10水平在预测重症肺炎患者短期预后中具有重要价值，且四者联合具有更高的预测价值。

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	沈建华程储记▲

关键词 ：重症肺炎, 磷脂酶A2, 降钙素原, 白介素-6, 白介素-10, 预后

Abstract：Objective To analyze the predictive value of serum phospholipase A2 (PLA2), procalcitonin (PCT), and interleukin (IL) -6, and IL-10 factors on the prognosis of patients with severe pneumonia. Methods A total of 160 patients with severe pneumonia admitted to Anqing Municipal Hospital of Anhui Province from October 2021 to May 2022 were selected. Serum levels of PLA2, PCT, IL-6, and IL-10 were detected before treatment. According to the prognosis within 28 days of admission, the patients were divided into the poor prognosis group and good prognosis group. Risk factors for poor prognosis in patients with severe pneumonia was analyzed. Serum PLA2, PCT, IL-6, IL-10 levels and their combined value in predicting poor prognosis in patients with severe pneumonia were analyzed. Results Among the 160 patients, 44 had poor prognosis within 28 days of admission, the poor prognosis rate was 27.50%, and 116 had good prognosis. The total time of invasive mechanical ventilation, pneumonia severity score, serum PLA2, PCT, IL-6, IL-10 levels and sequential organ failure assessment (SOFA) score in poor prognosis group were higher than those in good prognosis group (P＜0.05). Elevated serum PLA2, elevated PCT, elevated IL-6, elevated IL-10, and elevated SOFA score were risk factors for poor prognosis in patients with severe pneumonia (P＜0.05). Serum levels of PLA2, PCT, IL-6, and IL-10 and the area under the curve (AUC) values of the four combined to predict poor prognosis in patients with severe pneumonia were 0.729, 0.726, 0.738, 0.704, and 0.832, respectively. The predicted AUC values were all higher than those of detection alone (P＜0.05). Conclusion The levels of serum PLA2, PCT, IL-6, and IL-10 have important value in predicting the short-term prognosis of patients with severe pneumonia, and the combination of the four has higher predictive value.

Key words： Severe pneumonia Phospholipase A2 Procalcitonin Interleukin-6 Interleukin-10 Prognosis

基金资助:安徽省自然科学基金项目（1708085MH162）。

通讯作者: ▲通讯作者

作者简介: 沈建华（1987.4-），男，硕士；研究方向：急危重症患者的诊治。

引用本文:

沈建华程储记▲. 血清磷脂酶A2、降钙素原和白细胞介素6、10因子对重症肺炎患者预后的预测价值[J]. 中国医药导报, 2023, 20(8): 119-123.
SHEN Jianhua CHENG Chuji▲. Predictive value of serum phospholipase A2, procalcitonin, and interleukin 6 and 10 factors on prognosis of patients with severe pneumonia. 中国医药导报, 2023, 20(8): 119-123.

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