【摘要】 目的:探讨肺泡灌洗液(BALF)中可溶性血管内皮细胞选择素(s ES)对成人重症肺炎的诊断价值。方法:选择肺炎患者120例,依据病情严重程度分为重症肺炎组(n=60)及非重症肺炎组(n=60),另选与肺炎患者年龄、性别相匹配的非肺炎者60例作为对照组;采用酶联免疫吸附试验(ELISA)检测3组被检者BALF中s ES、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平;绘制受试者工作特征曲线(ROC),判断各指标对成人重症肺炎的诊断价值。结果:与对照组比较,重症肺炎组及非重症肺炎组BALF中s ES、IL-6及TNF-α水平显著升高,差异有统计学意义(P <0. 01);重症肺炎组BALF中s ES、TNF-α水平显著高于非重症肺炎组(P <0. 01),IL-6水平亦高于非重症肺炎组、但差异无统计学意义(P=0. 365); s ES的ROC曲线下面积、敏感性、特异性、阳性似然比均高于IL-6和TNF-α。结论:BALF中的s ES水平可作为成人重症肺炎诊断参考指标之一。更多还原

【Abstract】 Objective: To investigate the diagnostic value of soluble vascular endothelial cell selectin(s ES) in bronchoalveolar alveolar lavage fluid(BALF) for severe pneumonia in adult. Methods: 180 patients were included(60 cases of severe pneumonia group,60 cases of non-severe pneumonia group,and another 60 patients as control group were selected accordingly in age and gender). Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of s ES,interleukin-6 and tumor necrosis factor-α in BALF of each group. The receiver operating characteristic curve(ROC) was drawn and used to judge the diagnostic value of each index. Result: The levels of s ES,IL-6 and TNF-α in BALF of severe pneumonia group and non-severe pneumonia group were significantly higher than those of control group,differences were statistically significant(P < 0. 01). The levels of s ES and TNF-α in BALF of severe pneumonia group were higher than those of non-severe pneumonia group(P < 0. 01),the level of IL-6 in BALF of severe pneumonia group was higher than that of non-severe pneumonia group,but differences were not statistically significant(P = 0. 365). The ROC curve,sensitivity,specificity,and Youden index of s ES were higher than that of IL-6 and TNF-α. Conclusion: The level of s ES in BALF could serve as an effective index for severe pneumonia diagnosis in adults.更多还原