Ortqvist A, Hedlund J, Wretlind B, Carlström A, Kalin M
Department of Infectious Diseases, Danderyd Hospital, Stockholm, Sweden.
Scand J Infect Dis. 1995;27(5):457-62. doi: 10.3109/00365549509047046.
The diagnostic and prognostic value of admission serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) was investigated in 203 hospital-treated patients with community-acquired pneumonia (CAP). In serum samples obtained during the first 24 h after admission, IL-6 was detectable in 198 patients (98%), with a median value of 50 ng/l. Ten % of the patients had IL-6 values of 1000 ng/l. A clear positive correlation between IL-6 and CRP was found (r = 0.29, p < 0.0001). Patients with high IL-6 or CRP levels had longer duration of fever, longer hospital stay, and had less often recovered clinically or radiographically on follow-up weeks after discharge. A high IL-6, but not a high CRP, also seemed to be associated with a higher mortality. Bacteremic pneumococcal pneumonia had the highest levels of IL-6 (mean 2852 and median 420 ng/l) and CRP (mean 292 and median 285 mg/l). High IL-6 values were also seen in patients with non-bacteremic pneumococcal pneumonia, while all patients with pneumonia due to other bacterial, or viral, aetiology had IL-6 levels of < or = 300 ng/l. In conclusion, IL-6 and CRP are promising diagnostic and prognostic tools in the management of CAP. Further studies are needed to establish the usefulness of repeated measurements early in the hospital course of the disease.
对203例住院治疗的社区获得性肺炎（CAP）患者的入院血清白细胞介素-6（IL-6）和C反应蛋白（CRP）水平的诊断和预后价值进行了研究。在入院后最初24小时内采集的血清样本中，198例患者（98%）可检测到IL-6，中位数为50 ng/l。10%的患者IL-6值达到1000 ng/l。发现IL-6与CRP之间存在明显的正相关（r = 0.29，p < 0.0001）。IL-6或CRP水平高的患者发热持续时间更长、住院时间更长，出院后随访几周时临床或影像学恢复的情况也较少见。高IL-6水平似乎与较高的死亡率相关，而高CRP水平则不然。菌血症性肺炎球菌肺炎患者的IL-6水平最高（均值2852，中位数420 ng/l），CRP水平也最高（均值292，中位数285 mg/l）。非菌血症性肺炎球菌肺炎患者也有较高的IL-6值，而所有其他细菌或病毒病因引起的肺炎患者的IL-6水平均≤300 ng/l。总之，IL-6和CRP是CAP管理中有前景的诊断和预后工具。需要进一步研究以确定在疾病住院过程早期重复测量的实用性。
