动态监测重症肺炎患者血清IL-6、IL-10水平的临床意义

张芝亚，史武奇，刘振社

（咸阳市中心医院检验科，陕西 咸阳，712000）

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摘要：

目的 探讨动态监测重症肺炎患者血清中细胞因子IL-6、IL-10 的临床意义。方法 选取我院收治住院的120 例重症肺炎 患者，根据病程第10天的临床结果分为好转组（78例）和恶化组（42例）。采用酶联免疫法（ELISA）检测并比较两组患者入院后第1、5、10天血清中IL-6、IL-10水平。结果 与第1 天相比，两组患者血清中IL-6均呈下降趋势，且好转组明显低于恶化组（P<0.05）；与第1天相比，好转组患者血清IL-10呈下降趋势，恶化组IL-10呈明显上升趋势（P<0.05）。结论 血清IL-6、IL-10均参与重症肺炎的炎症反应，而动态监测血清IL-10能有效反应重症肺炎患者的临床预后，值得临床推广应用。

关键词：重症肺炎；IL-6；IL-10

中图分类号：R563文献标志码：A文章编号：2096-1413(2017)14-0048-02

Clinical significance of dynamic monitoring the level of serum IL-6 and IL-10 in patients with severe pneumonia
ZHANG Zhi-ya, SHI Wu-qi, LIU Zhen-she
(Department of Clinical Laboratory, Xianyang Central Hospital, Xianyang 712000, China)

ABSTRACT: Objective To explore the clinical significance and characteristic of change of dynamic monitoring the level of serum lnterleukin-6 (IL-6) and interleukin 10 (IL-10) in patients with severe pneumonia. Methods One hundred and twenty cases of patients with severe pneumonia in our hospital were selected and divided into recovered group (78 cases) and deterioration group (42 cases) according to the clinical results of the course of the 10th day. The level of serum IL-6 and IL-10 in the first day, fifth day and tenth day were compared and detecled by ELISA. Results Compared with the first day, the level of IL -6 in the two groups were both decreased, and the recovered group was lower than that of the deterioration group (P<0.05). Compared with the first day, the level of IL-10 of the recovered group decreased, while the IL-10 level of 5th day and 10th day in the deterioration group were higher than that of the first day respectively (P<0.05), but there was no significant difference between the 5th day and the 10th day (P<0.05). Conclusion Both IL-6 and IL-10 are associated with inflammatory response in severe pneumonia patients, the dynamic monitoring IL-10 levels can reflect the prognosis of patients with severe pneumonia, which is worthy of being widely applied in clinic.
KEYWORDS: severe pneumonia; IL-6; IL-10

参考文献：
[1] 龙胜规,龙胜泽.乌司他丁治疗重症肺炎43例疗效观察[J].广西医学,2010,32(12):1517-1518.
[2] ANTUNES G,EVANS SA,LORDAN JL,et al.Systemic cytokine levels in community -acquired pneumonia and their association with disease severity[J].Eur Respir J,2002,20(4):990-995.
[3] MANDELL LA,WUNDERINK RG,ANZUETO A,et al.Infectious diseases society of America/American thoracic societyconsensus guidelines on the management of community-acquired pneumonia in adults[J].Clin Infect Dis,2007,44(Suppl 2):27-72.
[4] 王昆,王瑾,王珊珊.亚胺培南/西司他丁对重症肺炎的降阶梯治疗疗效分析[J].中华医院感染学杂志,2005,15(7):805-807.
[5] 陈艺坛,黄圣排,陈志斌.东莨菪碱佐治重症肺炎并呼吸衰竭的疗效观察[J].临床肺科杂志,2006,11(11):707-708.
[6] 郭昆鹏,刘伊男,李科,等.成人重症社区获得性肺炎的血清炎性因子变化及临床意义探讨[J].中国医药指南,2012,10(32):420-422.
[7] 于露,刘跃建.肿瘤坏死因子-α 及转化生长因子-β1 在肺纤维化形成中的作用研究进展[J].实用医院临床杂志,2012,9(3):163-165.
[8] FINLAY BB,MCFADDEN G.Anti-immunology:evasion of the host immune system by bacterial and viral pathogens[J].Cell, 2006,124(4):767-782.

[9] SPITTLE A,RAZENBERGER M,KUPPER H,et al.Relationship between interleukin-6 plasma concentration in patients with sepsis, monocyte phenotype, monocyte phagocytic properties, and cytokine production [J].Clin Infect Dis,2000,31(6):1338-1420.
[10] 叶尚和,龚国良,郑海文,等.老年社区获得性肺炎细胞因子变化及中药干预的研究[J].中国中药杂志,2010,35(11):1486-1489.
[11] MULTZ AS,COHEN R.Systemic response to pneumonia in the critically ill patient Seminars in Respiratory[J].Semin Respir Infect,2003,18 (2):68-71.
[12] MOORE KW,DE WAAL MALEFYT R,COFFMAN RL,et al.Interleukin -10 and the interleukin -10 receptor [J].Annu Rev Immunol, 2001,19(1):683-765.