特定细胞因子谱可预测甲型流感肺炎的严重程度：一项前瞻性多中心初步研究。
Specific Cytokine Profiles Predict the Severity of Influenza A Pneumonia: A Prospectively Multicenter Pilot Study.
机构信息
Department of Respiratory & Critical Care Medicine, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, China.
Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 West Fifth Road, Xi'an, Shaanxi, China.
出版信息
Biomed Res Int. 2021 Oct 13;2021:9533044. doi: 10.1155/2021/9533044. eCollection 2021.
PURPOSE
Studying the cytokine profiles in influenza A pneumonia could be helpful to better understand the pathogenesis of the disease and predict its prognosis. . Patients with influenza A pneumonia (including 2009H1N1, H1N1, H3N1, and H7N1) hospitalized in six hospitals from January 2017 to October 2018 were enrolled (ClinicalTrials.gov ID, NCT03093220). Sputum samples were collected within 24 hours after admission and subsequently analyzed for cytokine profiles using a Luminex assay.
RESULTS
A total of 35 patients with influenza A pneumonia were included in the study. The levels of IL-6, IFN-, and IL-2 were increased in patients with severe influenza A pneumonia (n =10) ( = 0.002, 0.009, and 0.008, respectively), while those of IL-5, IL-25, IL-17A, and IL-22 were decreased compared to patients with nonsevere pneumonia ( = 0.0001, 0.009, 0.0001, and 0.006, respectively). The levels of IL-2 and IL-6 in the nonsurvivors ( = 5) were significantly higher than those in the survivors ( = 0.043 and 0.0001, respectively), while the levels of IL-5, IL-17A, and IL-22 were significantly lower ( = 0.001, 0.012, and 0.043, respectively). The IL-4/IL-17A ratio has the potential to be a good predictor (AUC = 0.94, < 0.05, sensitivity = 88.89%, specificity = 92.31%) and an independent risk factor (OR, 95% CI: 3.772, 1.188-11.975; < 0.05) for intermittent positive pressure ventilation (n = 9).
CONCLUSION
Significant dysregulation of cytokine profiles can be observed in patients with severe influenza A pneumonia.
目的
研究甲型流感肺炎中的细胞因子谱有助于更好地了解疾病的发病机制并预测其预后。本研究纳入了 2017 年 1 月至 2018 年 10 月期间六家医院收治的甲型流感肺炎（包括 2009H1N1、H1N1、H3N1 和 H7N1）患者（ClinicalTrials.gov ID：NCT03093220）。入院后 24 小时内采集痰标本，随后采用 Luminex 法分析细胞因子谱。
结果
本研究共纳入 35 例甲型流感肺炎患者。10 例重症甲型流感肺炎患者的 IL-6、IFN-γ和 IL-2 水平升高（ = 0.002、0.009 和 0.008），而与非重症肺炎患者相比，IL-5、IL-25、IL-17A 和 IL-22 水平降低（ = 0.0001、0.009、0.0001 和 0.006）。5 例死亡患者的 IL-2 和 IL-6 水平明显高于存活患者（ = 0.043 和 0.0001），而 IL-5、IL-17A 和 IL-22 水平明显降低（ = 0.001、0.012 和 0.043）。IL-4/IL-17A 比值可能是间歇性正压通气（n = 9）的良好预测指标（AUC = 0.94， < 0.05，敏感性 = 88.89%，特异性 = 92.31%）和独立危险因素（OR，95%CI：3.772，1.188-11.975； < 0.05）。
结论
重症甲型流感肺炎患者存在明显的细胞因子谱失调。
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