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山东大学学报(医学版) ›› 2015, Vol. 53 ›› Issue (2): 61-64.doi: 10.6040/j.issn.1671-7554.0.2014.501

• 临床医学 • 上一篇    下一篇

社区获得性肺炎患者的外周血TNF-α、sTREM-1、α1-APG水平

蔺晨, 郭芳, 季维娜, 于文成   

  1. 青岛大学附属医院呼吸内科, 山东 青岛 266021
  • 收稿日期:2014-07-30 发布日期:2015-02-10
  • 通讯作者: 于文成. E-mail:qdyuwencheng@163.com E-mail:qdyuwencheng@163.com

Levels of peripheral blood TNF-α, sTREM-1 and α1-APG in community acquired pneumonia patients

LIN Chen, GUO Fang, JI Weina, YU Wencheng   

  1. Department of Respiratory Medicine, the Affiliated Hospital of Qingdao University, Jinan 266021, Shandong, China
  • Received:2014-07-30 Published:2015-02-10

摘要: 目的 观察肿瘤坏死因子-α(TNF-α)、可溶性髓系细胞触发受体-1(sTREM-1)、α1-酸性糖蛋白(α1-APG)水平在社区获得性肺炎(CAP)患者外周血中变化,了解TNF-α、sTREM-1、α1-APG在CAP患者中的临床价值.方法 ELISA双抗夹心法检测110例CAP患者(CAP组)与52例对照组外周血TNF-α、sTREM-1水平,免疫散射速率比浊法检测α1-APG水平;观察CAP组住院第1天、第4天、第7天及不同病情时的TNF-α、sTREM-1、α1-APG水平变化趋势.结果 CAP组住院第1天、第4天及第7天的TNF-α、sTREM-1及α1-APG水平均显著高于对照组(P<0.001).经治疗后,第4天TNF-α、sTREM-1、α1-APG水平较第1天显著降低(P<0.001);第7天TNF-α、sTREM-1水平较第4天显著降低(P<0.001),第7天α1-APG水平较第4天升高(P<0.05).CAP组住院第1天,PSI高危患者TNF-α、sTREM-1、α1-APG水平显著高于中、低危患者(P<0.001).CAP组住院第1天,呼吸衰竭与非呼吸衰竭患者TNF-α、sTREM-1及α1-APG水平差异有统计学意义(P<0.001).CAP组住院第7天,与非糖皮质激素治疗患者相比,糖皮质激素治疗患者sTREM-1、α1-APG水平显著下降(P<0.01),但TNF-α水平差异无统计学意义(P>0.05).结论 在CAP患者中存在着炎性细胞因子TNF-α、sTREM-1、α1-APG的过度释放,TNF-α、sTREM-1、α1-APG水平可反映CAP患者的病情严重程度及治疗效果;糖皮质激素的应用可降低sTREM-1及α1-APG水平.TNF-α、sTREM-1、α1-APG可作为CAP患者诊断治疗及预后的指导指标.

关键词: 社区获得性肺炎, 可溶性髓系细胞触发受体-1, 肿瘤坏死因子-α, α1-酸性糖蛋白

Abstract: Objective To observe the changes of tumor necrosis factor-α (TNF-α), soluble triggering receptor-1 expressed on myeloid cells (sTREM-1), and α1-acid glycoprotein (α1-APG) levels in the peripheral blood of patients with community acquired pneumonia (CAP), and to understand their clinical significance in CAP patients. Methods Peripheral blood TNF-α and sTREM-1 levels of 110 CAP patients (CAP group) and 52 normal controls (control group) were detected by ELISA double antibody sandwich method, and peripheral blood α1-APG level was detected by immune turbidity method. The changing trends of TNF-α, sTREM-1 and α1-APG in CAP patients with different states of illness were observed on the 1st, 4th, and 7th days. Results TNF-α, sTREM-1 and α1-APG levels in CAP group on the 1st, 4th and 7th days were significantly higher than those in the control group (P<0.001). After the treatment, the TNF-α, sTREM-1 and α1-APG levels of CAP patients reduced significantly on the 4th day than the 1st day (P<0.001), the TNF-α and sTREM-1 levels on the 7th day reduced significantly than the 4th day (P<0.001), while the α1-APG level on the 7th day rosed than the 4th day (P<0.05). The TNF-α, sTREM-1 and α1-APG levels in PSI high-risk patients were significantly higher than those in middle-risk patients and low-risk patients on the 1st day (P<0.001). The TNF-α, sTREM-1 and α1-APG levels on the 1st day between respiratory failure patients and non-respiratory failure patients had statistical differences (P<0.001). On the 7th day after admission of CAP group, the sTREM-1 and α1-APG levels decreased significantly in glucocorticoid treatment patients than those in non-glucocorticoid treatment patients (P<0.01), but the TNF-α levels in these two groups showed no statistical difference (P>0.05). Conclusion There are excessive releases of inflammatory cytokines, including TNF-α, sTREM-1 and α1-APG, in CAP patients. Application of glucocorticoid can reduce the levels of sTREM-1 and α1-APG. The TNF-α, sTREM-1 and α1-APG levels can reflect the severity of illness and treatment effects of CAP patients, thus can be used as guide indicators for diagnosis, treatment and prognosis of CAP patients.

Key words: α1-acid glycoprotein, Soluble triggering receptor-1 expressed on myeloid cells, Tumor necrosis factor-α, Community acquired pneumonia

中图分类号: 

  • R563
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