重症肺炎患者BALF中细胞因子及α-SMA水平与疾病严重程度的研究
投稿时间:2017-06-29  修订日期:2017-07-19  点此下载全文
引用本文:李智鑫,严一核,孙雪东,吕铁,金烈洲.重症肺炎患者BALF中细胞因子及α-SMA水平与疾病严重程度的研究[J].医学研究杂志,2018,47(4):57-60
DOI: 10.11969/j.issn.1673-548X.2018.04.015
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作者单位E-mail
李智鑫 312000 绍兴市人民医院重症医学科  
严一核 312000 绍兴市人民医院重症医学科 47474811@qq.com 
孙雪东 312000 绍兴市人民医院重症医学科  
吕铁 312000 绍兴市人民医院重症医学科  
金烈洲 312000 绍兴市人民医院重症医学科  
基金项目:浙江省医药卫生一般研究计划项目(2016KYB308)
中文摘要:目的 探讨重症肺炎患者支气管肺泡灌洗液(BALF)中细胞因子水平及α-SMA水平反映疾病严重程度及肺纤维化程度的意义。方法 将笔者医院重症监护室收治的45例重症肺炎患者分为非ALI/ARDS组、ALI组及ARDS组,检测3组患者入科后支气管肺泡灌洗液的HGF、KGF及其他炎性因子水平,评价上述指标反映重症肺炎患者病情严重程度的意义,同时检测3组患者肺泡灌洗液中α-SMA水平,评价3组患者肺纤维化的程度。结果 3组患者BALF中的细胞因子HGF、KGF、IL-6、IL-8及MCP-1水平呈现ARDS组 > ALI组 > 非ALI/ARDS组(P<0.05);3组患者BALF中α-SMA水平呈现ARDS组 > ALI组 > 非ALI/ARDS(P<0.05)。结论 对于初入科的重症肺炎患者,细胞因子HGF、KGF、IL-6、IL-8及MCP-1水平越高,其病情相对越重,灌洗液中α-SMA水平可以反映肺纤维化程度,其水平越高,肺组织修复能力越差,对患者的预后有一定提示作用。
中文关键词:肺泡灌洗液  重症肺炎  炎性因子  肺纤维化
 
Study on Cytokines and α-SMA Levels and Severity of Disease in BALF Patients with Severe Pneumonia
Abstract:Objective To investigate the levels of cytokines and α-SMA in bronchoalveolar lavage fluid of patients with severe pneumonia reflected the severity of the disease and the degree of pulmonary fibrosis. Methods Forty five patients with severe pneumonia were divided into non-ALI/ARDS group, ALI group and ARDS group, levels of HGF, KGF and other inflammatory factors in bronchoalveolar lavage fluid were measured, evaluate the significance of the above indicators to reflecting the severity of severe pneumonia in patients with severe disease, Simultaneous detection of three groups of patients with alveolar lavage fluid α-SMA levels,,and evaluate the degree of the three groups of patients with pulmonary fibrosis. Results The levels of cytokines EGF, KGF, IL-6, IL-8 and MCP-1 in BALF were significantly higher in ARDS group > ALI group than in ALI/ARDS group (P<0.05), the levels of α-SMA in BALF group were ARDS > ALI > non-ALI/ARDS (P<0.05). Conclusion In this study, for newly diagnosed patients with severe pneumonia, the higher the levels of cytokines EGF, KGF, IL-6, IL-8 and MCP-1, the more severe the disease, the level of α-SMA in the lavage fluid can reflect the degree of pulmonary fibrosis, the level higher, the lung tissue repair capacity worse, there are clues for prognosis.
keywords:Alveolar lavage fluid  Severe pneumonia  Inflammatory factors  Pulmonary fibrosis
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