de Brito Rita de Cássia Coelho Moraes, Lucena-Silva Norma, Torres Leuridan Cavalcante, Luna Carlos Feitosa, Correia Jaílson de Barros, da Silva Giselia Alves Pontes
Institute of Integral Medicine Professor Fernando, Figueira (IMIP), Pediatrics, Rua Dona Benvinda de Farias 159, apt 1101, Boa Viagem, Recife, Pernambuco, Brazil.
Institute of Integral Medicine Professor Fernando Figueira (IMIP), Oncology and Aggeu Magalhães Research Center, Fiocruz-PE, Immunology, Recife, Brazil.
BMC Pulm Med. 2016 Dec 1;16(1):170. doi: 10.1186/s12890-016-0324-z.
To identify markers for earlier diagnosis of severe pneumonia, we assess the correlation between serum cytokine profile of children with different pneumonia severity.
In 25 hospitalized children, 7 with mild pneumonia and 18 with severe pneumonia, the serum concentration of 11 cytokines in three sampling times were dosed. Statistical analysis included parametric and non-parametric tests, Pearson correlation and ROC curve for cut-off definition of cytokines.
At admission, IL-6 serum levels were high in mild or severe pneumonia, and was associated to vomiting (P = 0.019) in both groups; and also to dyspnea (P = 0.012) and white blood cell count (P = 0.045) in patients with severe pneumonia. IL-10 levels were also high in patients with pneumonia and were associated to lymphocytosis (P = 0.025). The ROC curve of the IL-6:IL-10 serum levels ratio discriminated severe pneumonia cases at admission, and persistence of infection in the third day of antibiotic therapy, with positive predictive values of 93% and 89%, respectively.
The balance between IL-6 and IL-10 serum levels showed to be a more discriminative marker for severity definition and evaluation of recovery in patients with pneumonia.
为了确定早期诊断重症肺炎的标志物，我们评估了不同肺炎严重程度儿童的血清细胞因子谱之间的相关性。
在25名住院儿童中，7名患有轻度肺炎，18名患有重症肺炎，在三个采样时间点测定了11种细胞因子的血清浓度。统计分析包括参数检验和非参数检验、Pearson相关性分析以及用于确定细胞因子临界值的ROC曲线分析。
入院时，轻度或重症肺炎患儿的血清IL-6水平均较高，且在两组中均与呕吐相关（P = 0.019）；在重症肺炎患儿中还与呼吸困难（P = 0.012）和白细胞计数（P = 0.045）相关。肺炎患儿的IL-10水平也较高，且与淋巴细胞增多相关（P = 0.025）。IL-6:IL-10血清水平比值的ROC曲线在入院时可区分重症肺炎病例，并在抗生素治疗第三天可区分感染是否持续，阳性预测值分别为93%和89%。
血清IL-6和IL-10水平之间的平衡似乎是定义肺炎患者严重程度和评估恢复情况的更具鉴别性的标志物。
