摘要
目的分析心肌梗死患者血清肿瘤坏死因子α(TNF-α)、白介素-1β(IL-1β)和白介素18(IL-18)水平变化,并探讨其与急性呼吸衰竭病情的关系。方法选择2017年4月至2018年4月收治的64例心肌梗死合并Ⅰ型呼吸衰竭患者作为研究对象(病例组),其中轻度19例,中度28例,重度17例;同期50例健康体检者为对照组。采用双抗夹心酶联免疫吸附法(ELISA)检测受试者血清TNF-α、IL-1β、IL-18水平,采用急性生理和慢性健康评分(APACHE-Ⅱ)评估患者病情,同时检测患者肺功能,Pearson相关系数法分析血清TNF-α、IL-1β、IL-18与患者APACHE-Ⅱ评分和FEV1/FVC%的关系。结果病例组血清TNF-α、IL-1β、IL-18水平高于对照组(P<0.05),且随病情程度加重血清TNF-α、IL-1β、IL-18水平及APACHE-Ⅱ评分均呈升高趋势;病例组FEV1、FVC、FEV1/FVC%均低于对照组(P<0.05);病例组血清TNF-α、IL-1β、IL-18分别与APACHE-Ⅱ评分呈正相关(r=0.523、0.552、0.514,P=0.024、0.016、0.031),与FEV1/FVC%呈负相关(r=-0.635、-0.702、-0.691,P=0.009、0.000、0.002)。结论心肌梗死合并急性呼吸衰竭患者血清TNF-α、IL-1β、IL-18水平升高,与患者急性呼吸衰竭病情严重程度和肺功能损伤程度有关,可作为临床评估急性呼吸衰竭病情的检测指标。
Objective To investigate the changes of serum levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), IL-18 in patients with myocardial infarction,and to explore their correlation with the disease condition of patients with acute respiratory failure.Methods A total of 64 patients with myocardial infarction complicated by with type I respiratory failure who were admitted and treated in our hospital from April 2017 to April 2018 were enrolled as research objects(case group),of whom, there were 19 mild cases, 28 moderate cases and 17 severe cases. At the same time, 50 healthy subjects were enrolled as control group.The serum levels of TNF-α, IL-1β and IL-18 were measured by double antibody sandwich enzyme linked immunosorbent assay(ELISA), and acute physiological score and chronic health score(APACHE Ⅱ) were used to assess the patient’s condition,moreover, the lung function of patients was examined. The relationship between serum levels of TNF-α, IL-1β and IL-18 and APACHE Ⅱ score as well as FEV1/FVC% was analyzed by Pearson correlation coefficient method.Results The serum levels of TNF-α, IL-1β and IL-18 in case group were significantly higher than those in control group(P<0.05), moreover the serum levels of TNF-α, IL-1β, IL-18 and APACHE Ⅱ score were increased with the severity of the disease. However the FEV1, FVC and FEV1/FVC% in case group were significantly lower than those in control group(P<0.05). In addition the serum levels of TNF-α, IL-1β and IL-18 were positively correlated with APACHE Ⅱ scores(P<0.05),which were negatively correlated with FEV1/FVC%(P<0.01).Conclusion The serum levels of TNF-α, IL-1β and IL-18 in patients with myocardial infarction complicated by acute respiratory failure are increased,which are related to the severity of acute respiratory failure and the degree of lung function damage, which can be used as the indexes for evaluating the disease condition of patients with acute respiratory failure.
作者
冶秀花
YE Xiuhua(Department of ICU,The First People’s Hopspital of Xining City,Qinghai,Xining 810000,China)
出处
《河北医药》
CAS
2019年第21期3305-3308,共4页
Hebei Medical Journal
关键词
心肌梗死
急性呼吸衰竭
肿瘤坏死因子Α
白介素1Β
白介素18
myocardial infarction
acute respiratory failure
tumor necrosis factor-α
interleukin-1β
interleukin-18
