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目的通过监测和分析重症肺炎患者纤维支气管镜(纤支镜)灌洗液中降钙素原(PCT)和白介素(IL)-8水平的变化,探究其在临床疗效观察及预后判断等方面的意义。方法选取2012年8月至2013年11月收治的44例重症肺炎患者,在抗感染、对症治疗的基础上,每3天加1次纤支镜灌洗辅助治疗,分别留取第1次、第2次及第3次治疗时的支气管灌洗液标本,检测其中的PCT和IL-8含量,同时检测同一时期血清中PCT和IL-8的含量,进行统计学分析。结果病情好转的患者灌洗液和血清中PCT、IL-8浓度逐次下降,而病情恶化的患者其灌洗液和血清中PCT、IL-8浓度呈现逐次升高改变。其中每1次灌洗液中PCT、IL-8的浓度均较前1次检测结果有统计学差异(P均<0.05),而血清中PCT和IL-8的浓度仅在第3次检测时才出现有统计学意义的改变(P<0.05)。结论重症肺炎患者支气管灌洗液中PCT和IL-8的浓度动态变化与患者的病情发展密切相关,较血清中PCT、IL-8的变化更能及时、敏感地反映病情的严重程度,可作为评估临床疗效和预后的重要指标。
Objective To monitor and analyze the changes of procalcitonin (PCT) and interleukin (IL) -8 levels in bronchoscopy (bronchofibroscope) lavage fluid in patients with severe pneumonia and to explore its clinical efficacy and prognosis significance. Methods Forty-four patients with severe pneumonia admitted from August 2012 to November 2013 were selected and treated with bronchofiberscopy every three days on the basis of anti-infective and symptomatic treatment. The patients were divided into the first, The bronchoalveolar lavage fluid specimens at the second and third treatments were tested for PCT and IL-8 levels, and the levels of PCT and IL-8 in the serum during the same period were also measured for statistical analysis. Results The serum PCT and IL-8 levels gradually decreased in patients with improved condition, while the levels of PCT and IL-8 in the patients’ serum and serum deteriorated successively. The concentrations of PCT and IL-8 in each perfusion fluid were significantly different from those of the first one (P <0.05), while the concentrations of PCT and IL-8 in serum were only detected at the third test There was a statistically significant change (P <0.05). Conclusions The dynamic changes of PCT and IL-8 in bronchoalveolar lavage fluid in patients with severe pneumonia are closely related to the progression of the disease. Compared with the changes of serum PCT and IL-8, the changes of PCT and IL-8 can reflect the severity of the disease timely and sensitively, Evaluation of clinical efficacy and prognosis of the important indicators.