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目的:探讨炎症因子在大叶性肺炎患儿支气管肺泡灌洗液及血清中的表达水平及其临床意义。方法:收集2014年6月至2016年6月我院儿科收治的79例大叶性肺炎患儿为病例组,按照临床肺部感染评分(CPIS)分为重度组(n=46)和轻度组(n=33),于同期随机选取30例健康儿童为对照组,采用双抗体夹心酶联免疫吸附法(ELISA)检测各组支气管肺泡灌洗液及血清炎症因子如白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-17(IL-17)、肿瘤坏死因子(TNF-α)以及高迁移率族蛋白B1(HMGB1)表达水平。结果:重度组、轻度组血清IL-6、IL-8、IL-17、TNF-α及HMGB1水平高于对照组,重度组血清IL-6、IL-8、IL-17、TNF-α及HMGB1水平高于轻度组,差异有统计学意义(P<0.05)。病例组患儿支气管肺泡灌洗液IL-6、IL-8、IL-17、TNF-α及HMGB1水平高于血清,差异有统计学意义(P<0.05)。重度组、轻度组支气管肺泡灌洗液IL-6、IL-8、IL-17、TNF-α及HMGB1水平高于血清,差异有统计学意义(P<0.05),重度组支气管肺泡灌洗液、血清IL-6、IL-8、IL-17、TNF-α及HMGB1水平分别高于轻度组,差异有统计学意义(P<0.05)。经Spearman积矩相关分析,支气管肺泡灌洗液与血清中IL-6、IL-8、IL-17、TNF-α及HMGB1水平分别呈正相关关系(r=0.711、0.695、0.752、0.793、0.728,P<0.05)。结论:炎症因子在大叶性肺炎患儿支气管肺泡灌洗液及血清中呈高表达,并与大叶性肺炎病情严重程度密切相关,联合检测有助于早期评估病情。
Objective: To investigate the expression of inflammatory cytokines in bronchoalveolar lavage fluid and serum in children with lobar pneumonia and its clinical significance. Methods: A total of 79 patients with lobar pneumonia were enrolled in our pediatric department from June 2014 to June 2016. The patients were divided into severe group (n = 46) and mild group according to clinical pulmonary infection score (CPIS) (N = 33) .30 healthy children were randomly selected as the control group during the same period. The bronchoalveolar lavage fluid and serum inflammatory factors such as interleukin-6 IL-6, IL-8, IL-17, TNF-α and HMGB1 were detected by ELISA. Results: Serum levels of IL-6, IL-8, IL-17, TNF-α and HMGB1 in severe group and mild group were higher than those in control group. Serum levels of IL-6, IL-8, IL-17 and TNF- And HMGB1 levels higher than mild group, the difference was statistically significant (P <0.05). The levels of IL-6, IL-8, IL-17, TNF-α and HMGB1 in bronchoalveolar lavage fluid of patients in the case group were significantly higher than those in the serum (P <0.05). The levels of IL-6, IL-8, IL-17, TNF-α and HMGB1 in severe group and mild group were significantly higher than those in serum, the difference was statistically significant (P <0.05). The severe bronchoalveolar lavage The serum levels of IL-6, IL-8, IL-17, TNF-α and HMGB1 were significantly higher than those in mild group (P <0.05). After Spearman product moment correlation analysis, the levels of IL-6, IL-8, IL-17, TNF-αand HMGB1 in bronchoalveolar lavage fluid were positively correlated with each other (r = 0.711,0.695,0.752,0.793,0.728, P <0.05). Conclusion: Inflammatory cytokines are highly expressed in bronchoalveolar lavage fluid and serum in children with lobar pneumonia and are closely related to the severity of lobar pneumonia. Combined detection can be helpful for the early assessment of the disease.