CAJ | 학술논문

目的：探讨同型半胱氨酸(homocysteine,HCY)和白介素6(Interleukin 6,IL-6)水平鉴别诊断呼吸机相关性肺炎和抗生素治疗后的应用。方法186例呼吸机相关性肺炎,66例病毒性肺炎患者和80例健康对照组测定了血清HCY和IL-6水平并进行了对比性分析。将186例呼吸机相关性肺炎随机分成5组,在青霉素G,左氧氟沙星,头孢哌酮单独和组合治疗后,血清HCY和IL-6水平考核了呼吸机相关性肺炎的治疗效果。结果186例呼吸机相关性肺炎血清HCY和IL-6水平较之66例病毒性肺炎患者和80例健康对照组显著增高(P均<0．001),66例病毒性肺炎患者较之80例健康对照组,无明显差异。在抗生素药物单独或组合治疗后,呼吸机相关性肺炎痊愈者血清HCY和IL-6降至正常水平( P均>0．05),而未痊愈者仍然增高( P<0．05~<0．001)。结论 HCY和IL-6水平具有鉴别诊断呼吸机相关性肺炎和非细菌性感染的临床意义,并是考核抗生素治疗效果的有价值指标。
목적：탐토동형반광안산(homocysteine,HCY)화백개소6(Interleukin 6,IL-6)수평감별진단호흡궤상관성폐염화항생소치료후적응용。방법186례호흡궤상관성폐염,66례병독성폐염환자화80례건강대조조측정료혈청HCY화IL-6수평병진행료대비성분석。장186례호흡궤상관성폐염수궤분성5조,재청매소G,좌양불사성,두포고동단독화조합치료후,혈청HCY화IL-6수평고핵료호흡궤상관성폐염적치료효과。결과186례호흡궤상관성폐염혈청HCY화IL-6수평교지66례병독성폐염환자화80례건강대조조현저증고(P균<0．001),66례병독성폐염환자교지80례건강대조조,무명현차이。재항생소약물단독혹조합치료후,호흡궤상관성폐염전유자혈청HCY화IL-6강지정상수평( P균>0．05),이미전유자잉연증고( P<0．05~<0．001)。결론 HCY화IL-6수평구유감별진단호흡궤상관성폐염화비세균성감염적림상의의,병시고핵항생소치료효과적유개치지표。
Objective To explore the application of serum HCY and IL-6 levels in the differential diagnosis of patients with ventilator associated pneumonia after antibacterial drugs. Methods The serum levels of HCY and IL-6 were determined in 186 patients with ventilator associated pneumonia, 66 patients with viral pneumonia and 80 controls. The 186 patients with ventilator associated pneumonia were divided into five groups, and the serum levels of HCY and IL-6 were tested to evaluate the curative effect of penicillin G, levofloxacin and cefoperazone alone and combination therapy for patients with ventilator associated pneumonia. Results The serum levels of HCY and IL-6 in 186 patients with ventilator associated pneumonia were significantly higher than those in 66 patients with virus pneu-monia and 80 controls ( P <0. 001 ) . The serum levels of HCY and IL-6 in 66 patients with 66 virus pneumonia showed no significant difference with the controls (P>0. 05). After antibacterial drugs therapy, the serum levels of HCY and IL-6 were normal in patients with clinical convalescence ventilator associated pneumonia (P>0. 05), but they still increased in patients with no effectiveness (P<0. 05~0. 001). Conclusion HCY and IL-6 levels have the clinical significance on differential diagnosis between ventilator associated pneumonia and non-bacterial infection, and they are also valuable indexes to evaluate the curative effect after antibacterial drugs therapy.