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目的:探讨白介素-6(interleukin-6,IL-6)、触珠蛋白(haptoglobin,HPT)、淀粉样蛋白(serum amyloid A,SAA)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)伴肺炎中的表达变化和诊断价值。方法:选取2009年9月-2010年9月我院患者72例,健康对照19例,按COPD无、缓解期、急性加重期和肺炎有、无两种因素组合分为6组,酶联免疫吸附试验检测其血清IL-6、HPT、SAA含量,双因素协方差分析其差异,并用ROC曲线比较评估其在肺炎中的价值。结果:COPD疾病进展中IL-6、HPT、SAA存在升高,并且肺炎患者高于未伴肺炎患者,差异具有显著统计学意义(P<0.01或P<0.05)。ROC曲线显示:IL-6的曲线下面积(AUC)(0.928,95%可信区间为0.875～0.982),高于HPT的AUC(0.905,95%可信区间为0.831～0.978)和SAA的AUC(0.853,95%可信区间为0.768～0.937)。结论:COPD患者中,IL-6是诊断肺炎的较佳指标。
Objective: To investigate the expression of interleukin-6 (IL-6), haptoglobin (HPT) and serum amyloid A (SAA) in patients with chronic obstructive pulmonary disease (COPD) Changes in pneumonia and its diagnostic value. Methods: Seventy-two patients in our hospital from September 2009 to September 2010 were selected and divided into 6 groups according to the combination of COPD, remission, acute exacerbation and pneumonia. The levels of IL-6, HPT and SAA in serum were detected by adsorption test, and the differences were analyzed by two-factor covariance. The value of ROC curve in the diagnosis of pneumonia was also compared. Results: There was an increase in IL-6, HPT and SAA in the progression of COPD, and the difference was statistically significant (P <0.01 or P <0.05) in patients with pneumonia who were higher than those without pneumonia. The ROC curve showed that the area under the curve (AUC) of IL-6 (0.928, 95% confidence interval 0.875-0.982) was higher than that of HPT (0.905, 95% confidence interval 0.831-0.978) (0.853, 95% confidence interval 0.768 ~ 0.937). Conclusion: Among COPD patients, IL-6 is a better indicator for the diagnosis of pneumonia.