The Value of HNL,IL-1Ra/IL-1β Ratio Combined with Inflammatory Markers in the Diagnosis of Acute Bacterial Pneumonia and Viral Pneumonia and Its Relationship with Disease Severity
Objective To explore the value of neutrophil apolipoprotein(HNL)and interleukin-1 receptor antagonist(IL-1Ra)/interleukin-1β(IL-1β)ratio as auxiliary inflammatory markers to diagnose acute bacterial and viral pneumonia,and its their relationship with disease severity.Methods A retrospective study was conducted on 228 patients with acute pneumonia admitted to our hospital from September 2021 to May 2023,serving as the study group.According to the pathogen culture results,it was divided into a bacterial subgroup of 105 cases and a viral subgroup of 123 cases.According to the Acute Physiology and Chronic Health Evaluation System Ⅱ(APACHE Ⅱ)scoring results,the bacterial subgroup was classified into 32 mild cases,50 moderate cases,and 23 severe cases,whereas the viral subgroup was classified into 36 mild cases,66 moderate cases,and 21 severe cases.114 healthy volunteers who underwent physical examinations during the same period were established as the control group.The study compared the levels of HNL,IL-1Ra/IL-1β ratio,and inflammatory markers[C-reactive protein(CRP),procalcitonin(PCT)]between the study group and the control group,the bacterial subgroup and the viral subgroup,and patients with different levels of disease severity.The diagnostic value of each indicator for bacterial pneumonia and viral pneumonia and its relationship with disease severity were analyzed.Results The levels of serum HNL,IL-1β,CRP,and PCT in the study group were higher than those in the control group,while the IL-1Ra and IL-1Ra/IL-1β ratio were lower than those in the control group,with significant differences(P＜0.05).The levels of serum HNL,IL-1β,CRP,and PCT in the bacterial subgroup were higher than those in the viral subgroup,while the IL-1Ra and IL-1Ra/IL-1βratio were lower than those in the viral subgroup,with significant differences(P＜0.05).The receiver operating characteristic(ROC)curve showed that the combination of serum HNL,IL-1Ra/IL-1β ratio,CRP,and PCT had a high diagnostic value in the diagnosis of pneumonia,bacterial pneumonia,and viral pneumonia.The levels of serum HNL,IL-1β,CRP,and PCT in severe patients of the bacterial subgroup were higher than those in moderate patients,which were higher than those in mild patients;the levels of IL-1Ra and IL-1Ra/IL-1β ratio were lower than those in moderate patients,which were lower than those in mild patients;the differences were statistically significant(P＜0.05).The levels of serum HNL,IL-1β,and CRP in severe patients of the viral subgroup were higher than those in moderate patients,which were higher than those in mild patients;the levels of IL-1Ra and IL-1Ra/IL-1β ratio were lower than those in moderate patients,which were lower than those in mild patients;the differences were statistically significant(P＜0.05).The correlation analysis showed that the serum HNL and CRP were positively correlated with the severity of bacterial pneumonia and viral pneumonia,while the IL-1Ra/IL-1β ratio was negatively correlated with them;PCT was positively correlated with the severity of bacterial pneumonia(P＜0.05).Conclusion The levels of serum HNL,IL-1Ra/IL-1β ratio,CRP,and PCT are all observed to have certain correlations with the severity of bacterial pneumonia and viral pneumonia.Their combined detection can serve as an auxiliary indicator for clinical diagnosis of acute bacterial and viral pneumonia,providing some guidance for subsequent clinical treatment.
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