重症肺炎患者肺泡灌洗液细胞因子水平与预后的评估作用.

Objective: To investigate prognostic value of cytokine levels in bronchoalveolar lavage fluid in patients with severe pneumonia. Methods: Clinical data of 44 patients with severe pneumonia who were admitted to Intensive Care Unit of Hospital of Chengdu University of Traditional Chinese Medicine from September 2020 to July 2022 were retrospectively analyzed. Patients' gender, age, acute physiology and chronic health scoreⅡ （APACHEⅡ）, oxygenation index, cytokine detection in bronchoalveolar lavage fluid and 28-day prognosis were collected. SPSS27.0 statistical software was used to analyze and process data. Results: IL-17A level［ 51.15（1.85, 125.20） pg/ml vs 9.65（0.01, 19.95） pg/ml］ in bronchoalveolar lavage fluid and APACHEⅡ（ 27.29±5.27 vs 21.81± 5.00） in death group were significantly higher than those in survival group （P<0.05）, oxygenation index ［（131.14±60.95） mmHg vs （188.69±56.85） mmHg］ was worse than survival group （P<0.05）. Binary Logistic regression analysis showed that IL-17A, APACHE Ⅱ and oxygenation index were independent risk factors affecting prognosis of patients with severe pneumonia ［OR: 1.033（95%CI= 1.010~1.056）, 1.228（95%CI=1.022~1.477） and 0.984（95%CI=0.969~1.000）, all P<0.05］. ROC curve analysis showed that IL-17A, APACHEⅡ and oxygenation index had predictive value for 28-day death in patients with severe pneumonia, and AUC were 0.735 （95%CI=0.567~0.904）, 0.741（95%CI=0.575~0.906）, 0.789（95%CI=0.634~0.944）（all P<0.01）. Conclusion: IL-17A, APACHE Ⅱ and oxygenation index are all risk factors affecting prognosis of patients with severe pneumonia, which can all predict 28-day prognosis of patients. [ABSTRACT FROM AUTHOR]