摘要
目的 探究血清白细胞介素(IL)-6、淋巴细胞水平在甲型流感病毒及混合感染中的表达及与预后的相关性.方法 回顾性选取2021年1月至2023年12月江苏省人民医院宿迁医院收治的甲型流感病毒及混合感染患者70例作为研究组,另选取同期住院检查结果为未合并甲流感染的其他感染患者52例作为对照组.对比两组患者血清IL-6、淋巴细胞水平.依照随访研究组患者的预后情况,将其分为预后良好组54例和预后不良组16例.分析不同预后患者的性别、年龄、基础病史、临床症状、C反应蛋白(CRP)、白细胞、血清IL-6、淋巴细胞水平等差异.采用多因素Logistic回归分析对甲型流感病毒及混合感染预后的影响因素进行分析;采用受试者操作特征(ROC)曲线分析各项指标对预后不良的预测价值.结果 研究组IL-6水平为(19.12±0.95)ng/mL,高于对照组[(14.61±1.13)ng/mL],淋巴细胞水平为(0.49±0.16)×109/L,低于对照组[(0.73±0.14)× 109/L],差异均有统计学意义(P＜0.05).不同预后患者的性别构成比、年龄比较,差异均无统计学意义(P＞0.05);预后不良组与预后良好组的心脏病占比、高血压占比、脂肪肝占比、糖尿病占比、气促占比、咳嗽占比、CRP、白细胞、IL-6、淋巴细胞水平比较,差异均有统计学意义(P＜0.05).多因素Logistic回归分析结果显示,影响甲型流感病毒及混合感染预后的危险因素包括心脏病、IL-6、CRP、乏力、白细胞、高血压、气促、脂肪肝、发热、糖尿病、咳嗽、淋巴细胞(P＜0.05).IL-6与预后不良呈正相关(r=0.569,P＜0.05),淋巴细胞与预后不良呈负相关(r=-0.441,P＜0.05).IL-6与淋巴细胞联合预测甲型流感病毒及混合感染预后的曲线下面积(AUC)为0.794,高于IL-6与淋巴细胞单项检测的AUC(0.698、0.694),联合预测的价值较好.结论 IL-6、淋巴细胞在甲型流感病毒及混合感染的发生、发展过程中具有重要作用,其较低表达与患者不良预后密切相关.
Abstract
Objective To explore the expression of serum interleukin(IL)-6 and lymphocyte levels in influenza A virus and mixed in-fection and the correlation with prognosis.Methods Seventy patients with influenza A virus and mixed infection admitted to Jiangsu Province(Su-qian)Hospital from January 2021 to December 2023 was retrospectively selected as the study group,and 52 patients with other infections who were not complicated with influenza A virus infection during the same period were selected as the control group.Serum IL-6 and lymphocyte levels were compared between the two groups.According to the prognosis of the follow-up of the study group,the patients were divided into the good prognosis group(54 cases)and the poor prognosis group(16 cases).The differences of gender,age,basic medical history,clinical symptoms,C-reactive protein(CRP),white blood cells,serum IL-6 and lymphocyte levels in patients with different prognosis were analyzed.The prog-nostic factors of influenza A virus and mixed infection were analyzed using multivariate Logistic analysis.The predictive value of each index for poor prognosis was analyzed using receiver operating characteristic(ROC)curve.Results The level of IL-6 in the study group was(19.12±0.95)ng/mL,which was higher than that in the control group[(14.61±1.13)ng/mL],and the lymphocyte level was(0.49±0.16)× 109/L,which was lower than that in the control group[(0.73±0.14)× 109/L],the differences were statistically significant(P＜0.05).There were no statistically significant differences in gender composition ratio and age between patients with different prognosis(P＞0.05);there were statisti-cally significant differences in the proportion of heart disease,hypertension,fatty liver,diabetes,shortness of breath,cough,CRP,white blood cells,IL-6 and lymphocyte levels between the poor prognosis group and the good prognosis group(P＜0.05).Multivariate Logistic analysis showed that the risk factors affecting the prognosis of influenza A virus and mixed infection included heart disease,IL-6,CRP,fatigue,white blood cells,hypertension,shortness of breath,fatty liver,fever,diabetes,cough,and lymphocyte.IL-6 was positively correlated with poor prognosis(r=0.569,P＜0.05),and lymphocytes were negatively correlated with poor prognosis(r=-0.441,P＜0.05).The area under the curve(AUC)of IL-6 combined with lymphocytes in predicting the prognosis of influenza A virus and mixed infection was 0.794,which was higher than that of IL-6 and lymphocytes alone(0.698,0.694),and the value of combined prediction was better.Conclusion IL-6 and lymphocytes play an important role in the occurrence and development of influenza A virus and mixed infection,and their low expression is closely related to poor prognosis of patients.
维普
万方数据