IL-17及IL-33对急性肺损伤患者病情及预后的评估价值

doi:doi:10.3969/j.issn.1002-1949.08.007

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摘要目的探讨急性肺损伤（ALI）患者血清白细胞介素-17（IL-17）及白细胞介素-33（IL-33）水平与急性生理学与慢性健康状况Ⅱ（APACHEⅡ）评分的相关性，分析其对ALI的预后评估价值。方法选取2017年1月至2018年10月海口市第三人民医院收治的ALI患者128例，根据ALI患者生存情况分为存活组（ n =82）和死亡组（ n =46）。采用APACHEⅡ评分标准将ALI患者分为低危组（ n =30）、中危组（ n =46）和高危组（ n =52）。采用酶联免疫吸附法检测各组血清IL-17及IL-33水平。应用ROC曲线分析血清IL-17及IL-33水平预测ALI患者死亡的价值，Pearson相关分析ALI患者血清IL-17及IL-33水平与APACHEⅡ评分的相关性。结果死亡组血清IL-17（ng/L：27.83±7.36 vs. 14.60±4.25）及IL-33（ng/L：46.37±11.30 vs. 30.28± 8.46）均明显高于存活组（ P ＜0.05）。高危组血清IL-17（ng/L：26.20± 7.48 vs. 18.70±6.24, 13.18±4.25）、IL-33（ng/L：42.50±11.62 vs. 36.25±9.13,27.40± 7.34 ）及APACHEⅡ评分（分：29.60±3.70 vs.18.90±3.20, 9.70±1.80）、病死率（63.5% vs. 26.1%、6.7 %）均明显高于中危组和低危组（ P ＜ 0.05）。受试者工作特征（ROC）曲线分析显示，血清IL-17及 IL- 33水平预测ALI患者死亡的最佳截断值分别为18.45 ng/L及34.20 ng/L，两项联合预测ALI患者死亡的ROC曲线下面积（AUC）［0.890（95%CI 0.832～0.951）］明显高于单项，其敏感度和特异度为89.4%和84.7%。相关分析显示，死亡组血清IL-17及IL-33水平与APACHEⅡ评分均呈正相关（ r =0.816、0.730 ，P ＜ 0.01）。结论血清IL-17及IL-33水平与ALI患者病情严重程度及预后相关，IL-17及IL-33联合检测对预测ALI患者预后效果更好。

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	黄一桂
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关键词 ：白细胞介素-17（IL-17）, 白细胞介素-33（IL-33）, 急性肺损伤（ALI）, 预后评估

作者简介: 黄一桂（1983-），男，主治医师，E-mail:hygdahai@163.com。

引用本文:

黄一桂，陈钰，梁勇，许俊旭，吴挺实，钟婉红. IL-17及IL-33对急性肺损伤患者病情及预后的评估价值[J]. 中国急救医学, 2019, 39(8): 744-748.
Huang Yi-gui, Chen Yu, Liang Yong, Xu Jun-xu, Wu Ting-shi, Zhong Wan-hong. Value of IL-17 and IL-33 in evaluating the condition and prognosis of patients with acute lung injury. Chinese Journal of Critical Care Medicine, 2019, 39(8): 744-748.

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http://www.cnemergency.org.cn/CN/doi:10.3969/j.issn.1002-1949.08.007 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I8/744

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