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目的研究大叶性肺炎患儿支气管肺泡灌洗液(BALF)中炎症因子(IL-6、IL-10、IL-17、IL-33)水平与病情严重程度及病程的关系。方法选取2014年3月~2015年3月确诊为大叶性肺炎并行肺泡灌洗术(BAL)的患儿79例为研究对象,行BAL当天对患儿行临床肺部感染评分(CPIS),A组(22例)CPIS≥6,B组(57例)CPIS<6;根据病程,A、B两组再分为A1(10例)病程≤7天,A2(12例)病程>7天;B1(15例)病程≤7天、B2(42例)病程>7天。结果 IL-17水平A组明显高于B组,差异有统计学意义(P<0.05);IL-6、IL-17水平在(A1+B1)组明显大于(A2+B2)组,差异有统计学意义(P<0.05);IL-6水平A1组显著高于B1组,差异有统计学意义(P<0.05)。IL-10、IL-33在各组间差异均无统计学意义(均P>0.05)。结论 IL-6、IL-10、IL-17、IL-33均参与大叶性肺炎免疫过程。IL-6可反映急性期大叶性肺炎的严重程度。IL-17升高提示大叶性肺炎病情较重。
Objective To investigate the relationship between the levels of inflammatory cytokines (IL-6, IL-10, IL-17, IL-33) and severity of disease in bronchoalveolar lavage fluid (BALF) in children with lobar pneumonia. Methods A total of 79 children with lobar pneumonia complicated with bronchoalveolar lavage (BAL) diagnosed from March 2014 to March 2015 were enrolled in this study. The clinical pulmonary infection score (CPIS) Group A (22 cases) had CPIS≥6 and group B (57 cases) with CPIS <6. According to the course of disease, groups A and B were further divided into two groups: A1 ; B1 (15 cases) duration ≤ 7 days, B2 (42 cases) duration> 7 days. Results The level of IL-17 in group A was significantly higher than that in group B (P <0.05). The level of IL-6 and IL-17 in group A1 was significantly higher than that in group A2 + B2 Statistical significance (P <0.05); The level of IL-6 in A1 group was significantly higher than that in B1 group, the difference was statistically significant (P <0.05). IL-10 and IL-33 in all groups showed no significant difference (all P> 0.05). Conclusion IL-6, IL-10, IL-17 and IL-33 all participate in the immune process of lobar pneumonia. IL-6 can reflect the severity of acute lobar pneumonia. Elevated IL-17 suggests severe disease of lobar pneumonia.