社区获得性肺炎患者血清及支气管肺泡灌洗液中IL-6、IL-8和IL-10水平变化及其临床意义

摘要

目的：：探讨社区获得性肺炎( CAP)患者血清和支气管肺泡灌洗液( BALF)中炎症因子白细胞介素( IL)-6、IL-8和IL-10水平的变化及其临床意义。方法：选取CAP患者50例( CAP组),入院第1天进行临床肺部感染评分,<6分者为轻症组,≥6分者为重症组；选取同期10名健康志愿者为对照组。双抗体夹心酶联免疫吸附法测定CAP组入院第1天以及对照组血清和BALF中IL-6、IL-8、IL-10水平,同法测定CAP组入院第7、30天血清中IL-6、IL-8和IL-10水平。结果：CAP组入院第1天血清和BALF中IL-6、IL-8、IL-10水平均高于对照组(P<0.05~P<0.01)。 CAP重症组血清中IL-6、IL-10和BALF中IL-6、IL-8、IL-10浓度均明显高于轻症组(P<0.01)。 CAP组血清IL-6和IL-10水平均随病程呈下降趋势(P<0.01),在入院第7天和第30天均达到对照组水平(P>0.05)；而CAP组血清中IL-8水平在入院第30天仍保持较高水平,显著高于对照组(P<0.01)。结论：IL-6、IL-8和IL-10均参与了CAP患者局部和系统的炎症反应,BALF中IL-6、IL-8、IL-10和血清中IL-6、IL-10的水平可反映肺部感染的严重程度,检测血清中IL-6、IL-8和IL-10对CAP早期诊断有一定的临床价值。%Objective:To explore the levels of IL-6,IL-8 and IL-10 in serum and bronchoalveolar lavage fluid(BALF) of patients with community-acquired pneumonia( CAP) , and its clinical significance. Methods:The clinical pulmonary infection score of 50 patients with CAP were detected on the first day after admission. The patients with CPIS less than 6 and equal to or more than 6 were divided into the light group and severe group,respectively. Ten healthy people were set as the control group. The levels of IL-6,IL-8 and IL-10 in serum and BALF of the patients with CAP were determined by radioimmunoassay on the first day after admission. The levels of IL-6, IL-8 and IL-10 in serum of the patients with CAP were also measured on day 7 and 30 of admission. Results:The levels of IL-6,IL-8 and IL-10 in serum and BALF of CAP patients were significantly higher than those in control group on the first day after admission( P<0.05 to P<0. 01). The levels of IL-6 and IL-10 in serum and levels of IL-6,IL-8,IL-10 in BALF in severe CAP group were significantly higher in light CAP patients(P<0. 01). With the disease course prolonging,the levels of IL-6 and IL-10 decreased(P<0. 01),which arrived at the level of the control group on day 7 and 30 of admission(P>0. 05). The level of IL-8 in serum of CAP patients remained at a high level on day 30 of admission,which was significantly higher than that in control group(P <0. 01). Conclusions:The IL-6,IL-8 and IL-10 were involved in the pathogenesis of community-acquired pneumonia. The levels of IL-6 and IL-10 in serum and levels of IL-6,IL-8 and IL-10 in BALF can reflect the severity of pulmonary infection. The detection of IL-6,IL-8 and IL-10 in serum has certain clinical value in the early diagnosis of CAP.