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目的分析社区获得性肺炎(CAP)患者CURB-65评分与其临床指标、IL-1β、IL-4之间的相关性。方法研究中共收入80例研究对象,其中21例健康志愿者作为对照组;CAP病例共59例,其中轻症CAP25例,重症CAP34例。所有患者入院后采用CURB-65进行评分,常规行动脉血气分析,计算氧合指数,同时采用ELISA检测降钙素原(PCT)、IL-1β、IL-4。结果轻症肺炎组与健康对照组比较,其PaO2[(99.5±13.4)mmHgvs(105.1±9.4)mmHg]及PCT水平[(1.62±1.65)pg/mlvs(0.04±0.01)pg/ml]差异均无统计学意义(P>0.05);轻症肺炎组患者CURB-65评分(0.9±0.8vs0)、FiO2[(26.6±7.8)%vs21%、IL-1β[(118.79±32.29)pg/mlvs(9.33±2.51)pg/ml]、IL-4[(41.24±6.52)pg/mlvs(18.46±4.05)pg/ml]高于健康对照组,氧合指数(406.59±126.03vs500.45±44.82)则低于健康对照组(P<0.05);重症肺炎组CURB-65评分(3.5±0.7vs0.9±0.8&0)、FiO2[(41.9±12.0)%vs(26.6±7.8)%&21%)、PCT[(11.96±7.59)pg/mlvs(1.62±1.65)pg/ml&(0.04±0.01)pg/ml]、IL-1β[(200.13±48.27)pg/mlvs(118.79±32.29)pg/ml&(9.33±2.51)pg/ml]、IL-4[(55.41±13.71)pg/mlvs(41.24±6.52)pg/ml&(18.46±4.05)pg/ml]明显高于轻症肺炎组及健康对照组,而PaO2[(74.4±13.1)mmHgvs(99.5±13.4)mmHg&(105.1±9.4)mmHg]及氧合指数(204.14±110.10vs406.59±126.03&500.45±44.82)则明显低于轻症肺炎组及健康对照组,差异均有统计学意义(P<0.05)。CURB-65评分与氧合指数呈负相关(r=-0.833,P<0.05),而与PCT(r=0.900)、IL-1β(r=0.893)、IL-4(r=0.838)均呈正相关(P均<0.05)。结论 CAP患者的CURB-65评分与患者氧合指数、炎症反应指标呈明显相关性,可以作为评估重症肺炎的一种简易手段。
Objective To analyze the correlation between CURB-65 score and clinical parameters, IL-1β and IL-4 in patients with community-acquired pneumonia (CAP). Method study The Chinese population of 80 subjects, including 21 healthy volunteers as a control group; CAP cases a total of 59 cases, including mild CAP25 cases, severe CAP34 cases. All patients were scored by CURB-65 after admission and routine arterial blood gas analysis was performed to calculate the oxygenation index. At the same time, procalcitonin (PCT), IL-1β and IL-4 were detected by ELISA. Results Compared with the healthy control group, the PaO2 (99.5 ± 13.4) mmHgvs (105.1 ± 9.4) mmHg] and the PCT level [(1.62 ± 1.65) pg / ml vs (0.04 ± 0.01) pg / ml] (P <0.05); CURB-65 score (0.9 ± 0.8vs0), FiO2 [(26.6 ± 7.8)% vs21%, IL- 1β [(118.79 ± 32.29) pg / mlvs 9.31 ± 2.51) pg / ml] and IL-4 [(41.24 ± 6.52) pg / ml vs (18.46 ± 4.05) pg / ml] (P <0.05). The levels of CURB-65 in severe pneumonia group (3.5 ± 0.7 vs 0.9 ± 0.8 and 0), FiO2 (41.9 ± 12.0)% vs (26.6 ± 7.8) and 21% [(11.96 ± 7.59) pg / ml vs (1.62 ± 1.65) pg / ml vs (0.04 ± 0.01) pg / ml] and IL-1β [(200.13 ± 48.27) pg / ml vs (118.79 ± 32.29) pg / ml vs 2.51) pg / ml] and IL-4 [(55.41 ± 13.71) pg / ml vs (41.24 ± 6.52) pg / ml and (18.46 ± 4.05) pg / ml] were significantly higher than those of mild pneumonia and healthy controls (74.4 ± 13.1) mmHgvs (99.5 ± 13.4) mmHg and (105.1 ± 9.4) mmHg and oxygenation index (204.14 ± 110.10 vs406.59 ± 126.03 & 500.45 ± 44.82) were significantly lower than those in mild pneumonia and healthy controls Group, the difference was statistically significant (P <0.05). The score of CURB-65 was negatively correlated with oxygenation index (r = -0.833, P <0.05), but positively correlated with PCT (r = 0.900), IL- (All P <0.05). Conclusions The CURB-65 score of patients with CAP was significantly correlated with oxygenation index and inflammatory response index of patients, and could be used as a simple means to evaluate severe pneumonia.