CAJ | 학술논문

目的：：探讨重症肺炎患者外周血白细胞介素-6(IL-6)和 IL-18水平变化及其临床意义。方法：选择重症肺炎患者45例,临床肺部感染评分(CPIS)>6分15例,CPIS≤6分30例；常规治疗10 d 后好转26例,恶化19例。选择同期收治的普通肺炎患者33例作为对照。重症肺炎组分别于治疗前和病程第3、7天,对照组于就诊当天抽取外周静脉血3 mL,放射免疫法测定 IL-6,酶联免疫吸附法测定 IL-18。结果：治疗前,重症肺炎组外周血 IL-6和IL-18水平均高于对照组(t =7.672、8.376,P <0.05),CPIS 高分组患者高于 CPIS 低分组(t =6.685、6.652,P <0.05)。治疗好转组和恶化组患者外周血 IL-6和 IL-18水平随病程进展均逐渐降低(F时间=17.921、10.533,P <0.05),好转组患者外周血 IL-6和 IL-18水平降低程度显著大于恶化组(F组间=10.186、8.276,P <0.05)。 Pearson相关分析结果显示,治疗前重症肺炎患者外周血 IL-6与 IL-18水平呈显著正相关(r =0.517,P <0.001)。结论：外周血 IL-6和 IL-18水平可反映重症肺炎患者肺部感染的严重程度和预后。
목적：：탐토중증폐염환자외주혈백세포개소-6(IL-6)화 IL-18수평변화급기림상의의。방법：선택중증폐염환자45례,림상폐부감염평분(CPIS)>6분15례,CPIS≤6분30례；상규치료10 d 후호전26례,악화19례。선택동기수치적보통폐염환자33례작위대조。중증폐염조분별우치료전화병정제3、7천,대조조우취진당천추취외주정맥혈3 mL,방사면역법측정 IL-6,매련면역흡부법측정 IL-18。결과：치료전,중증폐염조외주혈 IL-6화IL-18수평균고우대조조(t =7.672、8.376,P <0.05),CPIS 고분조환자고우 CPIS 저분조(t =6.685、6.652,P <0.05)。치료호전조화악화조환자외주혈 IL-6화 IL-18수평수병정진전균축점강저(F시간=17.921、10.533,P <0.05),호전조환자외주혈 IL-6화 IL-18수평강저정도현저대우악화조(F조간=10.186、8.276,P <0.05)。 Pearson상관분석결과현시,치료전중증폐염환자외주혈 IL-6여 IL-18수평정현저정상관(r =0.517,P <0.001)。결론：외주혈 IL-6화 IL-18수평가반영중증폐염환자폐부감염적엄중정도화예후。
Aim: To explore the levels of peripheral blood interleukin-6(IL-6) and IL-18 in patients with severe pneu-monia and the significance. Methods: A total of 45 patients with severe pneumonia were collected, out of which 15 cases with the clinical pulmonary infection score(CPIS) > 6 and 30 cases with CPIS≤6. After 10 days treatment, 26 cases were improved and 19 cases were deteriorating. Another 33 cases of ordinary pneumonia at the same period in the hospital were the control group. Peripheral blood IL-6 and IL-18 levels were determined by radioimmunoassay and enzyme-linked immu-nosorbent assay before the treatment and on the 3rd,7th day of the course of disease. Results: The peripheral blood IL-6 and IL-18 levels in severe pneumonia group before treatment were higher than those in the control group(t = 7. 672,8. 376, P < 0. 05). The peripheral blood IL-6 and IL-18 levels in high CPIS group were higher than those in low CPIS group before treatment(t = 6. 685,6. 652,P < 0. 05). The peripheral blood IL-6 and IL-18 levels in the improved group and deteriorating group gradually declined with time(Ftime = 17. 921,10. 533,P < 0. 05),and the peripheral blood IL-6 and IL-18 levels and the decreased magnitude in the improved group were greater than those of the deteriorating group(Fgroup = 10. 186,8. 276, P < 0. 05). Pearson correlation analysis showed that the peripheral blood IL-6 level was positively correlated with IL-18(r =0. 517,P < 0. 001) in severe pneumonia group before treatment. Conclusion: Peripheral blood IL-6 and IL-18 could reflect the severity of lung infection and prognosis of severe pneumonia patients.