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| 血清IL-4、IL-6、IL-33与老年重症肺炎患者肠道菌群的相关性分析及对预后的影响 |
| Correlation Analysis of Serum IL-4, IL-6, IL-33 and Intestinal Microflora in Elderly Patients With Severe Pneumonia and Their Influence on Prognosis |
| 投稿时间：2023-01-06 修订日期：2023-01-06 |
| DOI： |
| 中文关键词: 老年 重症肺炎 IL-4 IL-6 IL-33 肠道菌群 预后 相关性 |
| 英文关键词: Elderly Severe pneumonia IL-4 IL-6 IL-33 Intestinal flora Prognosis Correlation |
| 基金项目:四川省卫生和计划生育委员会科研课题（编号：18PJ405）；成都大学附属医院院级科研课题（编号：2020YYZ31） |
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| 中文摘要: |
| 目的：探究老年重症肺炎患者血清白介素（IL）-4、IL-6、IL-33与肠道菌群变化的相关性及预后影响因素。方法：选取我院2020年1月-2022年1月期间收治的老年重症肺炎患者中筛选82例纳入重症组，从同期老年健康体检志愿者中选取50例纳入正常组。对比两组的IL-4、IL-6、IL-33与肠道菌群水平差异，Pearson相关系数分析肠道菌群与IL-4、IL-6、IL-33水平相关性，根据重症组随访6个月的预后情况分为生存组55例、死亡组27例，对比生存组、死亡组的临床因素差异，多因素Logistic回归模型分析重症肺炎死亡的影响因素。结果：（1）对比正常组，重症组的IL-4、IL-6、IL-33水平均明显升高（P<0.05）；（2）对比正常组，重症组的大肠埃希菌水平均明显升高且双歧杆菌水平明显降低（P<0.05）；（3）大肠埃希菌与IL-4、IL-6、IL-33均呈正相关，双歧杆菌与IL-4、IL-6、IL-33均呈负相关；（4）对比生存组，死亡组年龄、急性生理和慢性健康（APACHE-Ⅱ）评分、IL-4、IL-6、IL-33、大肠埃希菌、机械通气比例、餐后2h平卧比例均明显更高且双歧杆菌明显更低（P<0.05）；（5）重症肺炎死亡的独立危险因素包括年龄增加、APACHE-Ⅱ评分升高、IL-4升高、IL-6升高、IL-33升高、大肠埃希菌升高、机械通气、餐后2h平卧且独立保护因素是双歧杆菌升高。结论：老年重症肺炎患者存在明显的炎症反应与肠道菌群失衡，患者的IL-4、IL-6、IL-33、大肠埃希菌、双歧杆菌异常变化并且存在密切关系，老年重症肺炎患者的年龄、机械通气、餐后体位等因素均会影响其预后生存结局。 |
| 英文摘要: |
| Objective: To explore the correlation between serum interleukin (IL)-4, IL-6, IL-33 and intestinal flora in elderly patients with severe pneumonia and the influencing factors of prognosis. Methods: 82 elderly patients with severe pneumonia who were admitted in our hospital from January 2020 to January 2022 were selected to be included in the severe group, and 50 elderly health volunteers from the same period were selected to be included in the normal group. The levels of IL-4, IL-6, IL-33 and intestinal flora in the two groups were compared. Pearson correlation coefficient was used to analyze the correlation between intestinal flora and the levels of IL-4, IL-6, and IL-33. According to the prognosis of the severe group at 6 months after follow-up, they were divided into survival group with 55 patients and death group with 27 patients. The differences of clinical factors between survival group and death group were compared. The influencing factors of death from severe pneumonia were analyzed by multivariate Logistic regression model. Results: (1) Compared with the normal group, the levels of IL-4, IL-6 and IL-33 in the severe group were significantly higher (P<0.05). (2) Compared with the normal group, the level of Escherichia coli in the severe group was significantly higher and the level of bifidobacterium was significantly lower (P<0.05). (3) Escherichia coli was positively correlated with IL-4, IL-6 and IL-33, while bifidobacterium was negatively correlated with IL-4, IL-6 and IL-33. (4) Compared with the survival group, the age, acute physiology and chronic health (APACHE-Ⅱ) score, IL-4, IL-6, IL-33, Escherichia coli, the proportion of mechanical ventilation, and the proportion of lying flat 2 hours after meal in the death group were significantly higher and the bifidobacterium were significantly lower (P<0.05). (5) The independent risk factors of death from severe pneumonia included increased age, increased APACHE-Ⅱ score, increased IL-4, increased IL-6, increased IL-33, increased Escherichia coli, mechanical ventilation, lying flat 2 hours after meal, and the independent protective factor was increased bifidobacterium. Conclusion: Elderly patients with severe pneumonia have obvious inflammatory response and intestinal flora imbalance, and abnormal changes of IL-4, IL-6, IL-33, Escherichia coli and bifidobacterium are closely related. Age, mechanical ventilation, after meal position and other factors in elderly patients with severe pneumonia can affect their prognosis and survival outcome. |
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