【摘要】 目的 研究血清分泌性白细胞蛋白酶抑制剂（SLPI）、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)对重症肺炎诊断及预后的评估作用。方法 选择2023年3月至2024年3月期间新疆医科大学第一附属医院收治的95例重症肺炎患者和125例普通肺炎患者分别作为研究的重症肺炎组和普通肺炎组，另取同期体检的100名健康志愿者作为对照组，比较三组血清SLPI、IL-8、TNF-α。根据重症肺炎组患者28 d的生存情况分为死亡亚组（n=20）和存活亚组（n=75），比较两组间临床资料及SLPI、IL-8、TNF-α，采用多因素logistic回归分析重症肺炎患者死亡的影响因素，采用ROC曲线分析血清SLPI、IL-8、TNF-α对重症肺炎的诊断价值及对死亡的预测价值。结果 三组血清SLPI水平比较为：重症肺炎组<普通肺炎组<对照组，血清IL-8、TNF-α水平比较为：重症肺炎组>普通肺炎组>对照组，差异有统计学意义（P<0.05）；重症肺炎组中死亡亚组患者的血清SLPI水平低于存活亚组，年龄及血清CRP、IL-8、TNF-α水平高于存活亚组，差异有统计学意义（P<0.05）;SLPI水平升高是重症肺炎患者死亡的保护因素，IL-8、TNF-α水平升高是重症肺炎患者死亡的危险因素（P<0.05）；血清SLPI、IL-8、TNF-α对重症肺炎具有诊断价值，对重症肺炎死亡具有预测价值。结论 血清SLPI水平降低、IL-8及TNF-α水平增加与重症肺炎发生及死亡风险增加有关。更多还原

【Abstract】 Objective To investigate the role of serum secretory leukocyte protease inhibitor(SLPI), interleukin-8(IL-8), and tumor necrosis factor-α(TNF-α) in the diagnosis and prognosis of severe pneumonia. Methods A total of 95 patients with severe pneumonia and 125 patients with common pneumonia were admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2023 to March 2024.They were selected as the severe pneumonia group and the common pneumonia group, respectively. Additionally, 100 healthy volunteers who underwent physical examinations during the same period were chosen as the control group. The differences in serum levels of SLPI, IL-8, and TNF-α among the three groups were compared. Patients with severe pneumonia were further divided into based on their 28-day survival outcomes into a death subgroup(n=20) and a survival subgroup(n=75). The differences in clinical data, SLPI, IL-8, and TNF-α between the two groups were compared. Additionally, multivariate logistic regression was used to analyze the influencing factors of death in patients with severe pneumonia were analyzed by multivariate logistic regression. The diagnostic value for severe pneumonia and the predictive value for death of serum SLPI, IL-8and TNF-α were analyzed by ROC curve. Results The levels of serum SLPI among the three groups were as follows: severe pneumonia group <common pneumonia group <control group. The levels of serum IL-8 and TNF-α followed a different trend: severe pneumonia group >common pneumonia group >control group. This difference was statistically significant(P<0.05). In the severe pneumonia group, the serum SLPI level in the death subgroup was lower than that in the survival subgroup.Additionally,the levels of age,serum CRP,IL-8,and TNF-α were higher in the death subgroup compared to the survival subgroup,with statistical significance(P<0.05).An elevated SLPI level was found to be a protective factor for death in patients with severe pneumonia,while elevated IL-8 and TNF-α levels were identified as the risk factors for death in these patients (P<0.05).Serum SLPI,IL-8,and TNF-α were determined to have diagnostic and predictive value for death in severe pneumonia cases.Conclusion The decrease in serum SLPI levels and the increase in IL-8 and TNF-α levels are associated with the occurrence and increased risk of death in severe pneumonia.更多还原