CAJ | 학술논문

目的：观察重症肺炎患者诱导痰与外周血的炎症介质水平变化，探讨其局部与全身炎症反应状态。方法：留取66例行有创机械通气的重症肺炎患者入组第1、4、7天及出院或死亡当天的外周静脉血及诱导痰标本，测定标本sTREM-1、TNF-α、IL-10水平；根据预后将患者分为存活组（31例）与死亡组（35例），观察两组血浆与诱导痰的sTREM-1、TNF-α及IL-10水平变化趋势。结果：死亡组诱导痰及血浆sTREM-1、TNF-α、IL-10水平均高于存活组（P<0.05）；随着时间推移，存活组血浆及诱导痰sTREM-1、TNF-α、IL-10水平呈下降趋势，而死亡组水平均保持高值甚至进一步升高。结论：重症肺炎患者存在全身及气道局部的过度炎症反应，可以诱导痰及血浆sTREM-1、TNF-α、IL-10水平判断患者预后。
목적：관찰중증폐염환자유도담여외주혈적염증개질수평변화，탐토기국부여전신염증반응상태。방법：류취66례행유창궤계통기적중증폐염환자입조제1、4、7천급출원혹사망당천적외주정맥혈급유도담표본，측정표본sTREM-1、TNF-α、IL-10수평；근거예후장환자분위존활조（31례）여사망조（35례），관찰량조혈장여유도담적sTREM-1、TNF-α급IL-10수평변화추세。결과：사망조유도담급혈장sTREM-1、TNF-α、IL-10수평균고우존활조（P<0.05）；수착시간추이，존활조혈장급유도담sTREM-1、TNF-α、IL-10수평정하강추세，이사망조수평균보지고치심지진일보승고。결론：중증폐염환자존재전신급기도국부적과도염증반응，가이유도담급혈장sTREM-1、TNF-α、IL-10수평판단환자예후。
Objective:To observe the changes of inflammatory mediators in induced sputum and plasma of patients with severe pneumonia and ex-plore the state of local and systematic inflammatory response in severe pneumonia. Methods:Peripheral blood and induced sputum were collectted on days 1, 4, 7 and the day of discharge or death of 66 pneumonia patients with invasive mechanical ventilation. The induced sputum and plasma lev-els of sTREM-1, TNF-αand IL-10 were determined. The subjects were divided into two groups according to the prognosis, such as survivors and non-survivors in severe pneumonia. Results:Plasma induced sputum and levels of sTREM-1, IL-10 and TNF-αin non-survivors were all higher than survivors (P<0.05). Induced sputum and plasma sTREM-1, TNF-αand IL-10 levels were gradually decreased in survivors, but maintained at higher levels even further increased in non-survivors. Conclusions:There are excessive inflammatory response of local and systematic in patients with se-vere pneumonia, which probably can be used to judge the prognosis of patients by sTREM-1, TNF-αand IL-10 levels.