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新型冠状病毒肺炎肺炎中细胞因子谱与肺损伤的关系。

Association between cytokine profiles and lung injury in COVID-19 pneumonia.

机构信息

Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, China.

Department of Geriatrics, Zhongshan Hospital, Xiamen University; Teaching Hospital of Fujian Medical University, Xiamen, Fujian, China.

出版信息

Respir Res. 2020 Jul 29;21(1):201. doi: 10.1186/s12931-020-01465-2.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a new respiratory and systemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The purpose of the present study was to investigate the association between cytokine profiles and lung injury in COVID-19 pneumonia.

METHODS

This retrospective study was conducted in COVID-19 patients. Demographic characteristics, symptoms, signs, underlying diseases, and laboratory data were collected. The patients were divided into COVID-19 with pneumonia and without pneumonia. CT severity score and PaO/FiO ratio were used to assess lung injury.

RESULTS

106 patients with 12 COVID-19 without pneumonia and 94 COVID-19 with pneumonia were included. Compared with COVID-19 without pneumonia, COVID-19 with pneumonia had significantly higher serum interleukin (IL)-2R, IL-6, and tumor necrosis factor (TNF)-α. Correlation analysis showed that CT severity score and PaO/FiO were significantly correlated with age, presence of any coexisting disorder, lymphocyte count, procalcitonin, IL-2R, and IL-6. In multivariate analysis, log IL6 was the only independent explanatory variables for CT severity score (β = 0.397, p < 0.001) and PaO/FiO (β = - 0.434, p = 0.003).

CONCLUSIONS

Elevation of circulating cytokines was significantly associated with presence of pneumonia in COVID-19 and the severity of lung injury in COVID-19 pneumonia. Circulating IL-6 independently predicted the severity of lung injury in COVID-19 pneumonia.

摘要

背景

2019 年冠状病毒病(COVID-19)是一种由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染引起的新发呼吸道和全身疾病。本研究旨在探讨 COVID-19 肺炎中细胞因子谱与肺损伤的关系。

方法

本回顾性研究纳入 COVID-19 患者。收集人口统计学特征、症状、体征、基础疾病和实验室数据。将患者分为 COVID-19 合并肺炎和无肺炎。采用 CT 严重程度评分和 PaO/FiO 比值评估肺损伤。

结果

共纳入 12 例 COVID-19 无肺炎和 94 例 COVID-19 合并肺炎患者。与 COVID-19 无肺炎相比,COVID-19 合并肺炎患者血清白细胞介素(IL)-2R、IL-6 和肿瘤坏死因子(TNF)-α明显升高。相关性分析显示,CT 严重程度评分和 PaO/FiO 与年龄、是否存在合并症、淋巴细胞计数、降钙素原、IL-2R 和 IL-6 显著相关。多变量分析显示,logIL6 是 CT 严重程度评分(β=0.397,p<0.001)和 PaO/FiO(β=-0.434,p=0.003)的唯一独立解释变量。

结论

循环细胞因子水平升高与 COVID-19 合并肺炎及 COVID-19 肺炎肺损伤严重程度显著相关。循环 IL-6 独立预测 COVID-19 肺炎肺损伤的严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/675d/7391580/4d502ae7e8a1/12931_2020_1465_Fig1_HTML.jpg

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