罗　彬，冯　琦，姜　华

重症肺炎患者肺泡灌洗液炎症因子水平与预后的相关性研究

罗彬1，冯琦2，姜华1

1.新疆医科大学第五附属医院重症医学科，新疆乌鲁木齐830011；

2.新疆医科大学第五附属医院肾病科，新疆乌鲁木齐830011

目的 探讨重症肺炎肺泡灌洗液炎症因子水平和患者预后情况之间的联系的相关性。方法 从该院2015年2月—2016年3月住院患者中整群选择重症肺炎ICU患者进行对照试验，一共65例，对重症肺炎患者肺泡灌洗液和外周静脉血的细胞因子进行检测。结果①随着病程的延长，两组患者在血液和肺泡灌洗液中的IL-6有所降低，组间差异无统计学意义，血液第7天，可见IL-6与患者预后没有显著的相关性；②随着病程的延长，无效组血液和肺泡灌洗液中IL-10水平有所升高，好转组血液和肺泡灌洗液中IL-10水平有所降低，第4天（10.11±2.64）pg/mL比（3.10±2.49）pg/mL和第7天（18.42±6.22）pg/mL比（2.02±1.02）pg/mL，组间差异有统计学意义（P＜0.05）。由此说明，患者的IL-10水平变化与预后有一定相关性。结论 了解炎症细胞因子与重症肺炎病情的之间的关系，对患者预后方面具有诊断价值，从而进一步了解细胞因子在重症肺炎中的临床意义。

重症肺炎；肺泡灌洗液；炎症因子；预后；相关性

1.Department of Critical Care Medicine，the Fifth Affiliated Hospital of Xinjiang Medical University，Urumqi，Xinjiang，830011 China；2.Department of Ephropathy，the Fifth Affiliated Hospital，Xinjiang Medical University，Urumqi，Xinjiang，830011 China

［Abstract］Objective To study correlation of inflammatory factors level of bronchoalveolar lavage fluid with severe pneumonia in patients and prognosis.Methods 65 cases of severe pneumonia in ICU patients were selected in February 2015 to March 2016 in our hospital，cell factors were determited of BALF and peripheral venous blood of severe pneumonia patients.Results The level of IL-6 in the blood and BALF of improvement group and invalid group had a downward trend with the course of the disease，but without statistical significance.It showed that IL-6 level had no correlation with the prognosis of patients.Beside，the level of IL-10 in the blood and BALF of invalid group had a rising trend with the course of the disease，the level of IL-10 in theblood and BALF of improvement group had a downward trend with the course of the disease.On the 4 days（10.11±2.64）pg/ mL to（3.10±2.49）pg/mL and 7 days（18.42±6.22）pg/mL to（2.02±1.02）pg/mL，the difference was statistically significant（P＜0.05）between groups.It indicated that the patient's level of IL-10 had correlation with prognosis.Conclusion Understand the relationship between inflammatory cytokines and severe pneumonia condition and have a diagnostic value of the prognosis of patients，so as to understand the clinical significance of cytokines in severe pneumonia in further.

［Key words］Severe pneumonia；Bronchoalveolar lavage fluid；Inflammation factors；The prognosis；The correlation

重症肺炎一般是由严重的细菌或病毒感染所致的肺部炎症，临床治疗难度较大。早期对重症肺炎发展至后期的患者采取积极抗生素抗感染治疗，机体反应和预后却可能完全不同［1-4］。随着对其临床病理生理研究不断摄入，发现促炎介质与抗炎介质的平衡能够维持机体内环境的稳态［5-8］。……