血清降钙素原、CRP与IL-37水平变化在慢性重型乙型肝炎并细菌感染的作用
发布时间：2018-11-01 14:23
【摘要】：目的:通过监测慢性重型肝炎并细菌感染血清降钙素原(PCT)、CRP、IL-37在治疗中水平变化,联合检测PCT、CRP、IL-37水平早期发现细菌感染,持续监测其水平变化预测慢性重型肝炎的预后,探讨其在乙肝病毒感染重症化的作用。方法:选择2012年12月至2014年10月来南昌大学第一附属医院感染科住院的慢性重型乙型肝炎合并细菌感染患者30例作为观察组;选取30例慢性重型乙型肝炎为对照组。检测比较入院前观察组、对照组血清PCT、CRP、IL-37水平。将观察组分为好转组(12例)和疾病进展组(18例),检测入院前、抗感染治疗7天、治疗14天血清PCT、CRP、IL-37水平,分析PCT、CRP、IL-37水平与预后的关系,并观察慢性重型乙型肝炎合并细菌感染的肝功能ALT、PTA与IL-37水平是否存在相关性。结果:1、观察组治疗前血清PCT水平、CRP水平、IL-37水平明显高于对照组,差异具有统计学意义(P0.05)。2、疾病进展组和好转组治疗前、治疗14天的CRP差异较小(P0.05),无统计学意义.,疾病进展组CRP治疗7天时高于好转组,差异具有统计学意义(P0.05)。组内不同时间段比较,疾病进展组CRP水平呈先上升后下降趋势(F=5.872,P=0.032),而好转组则呈缓慢下降趋势(F=3.529,P=0.041)。3、疾病进展组治疗7天、14天时PCT水平均不同程度明显高于好转组,差异具有统计学意义(P0.05)。组内不同时间段比较,疾病进展组PCT水平呈显著上升趋势(F=24.864,P=0.001),而好转组则在治疗7天后呈下降趋势(F=4.247,P=0.037)。4、疾病进展组治疗7天、14天时IL-37水平均不同程度明显低于好转组,差异具有统计学意义(P0.05)。组内不同时间段比较,疾病进展组IL-37水平呈显著下降趋势(F=6.852,P=0.014),而好转组则呈上升趋势(F=9.125,P=0.021)。5、将慢性重型肝炎合并细菌感染患者的ALT、PTA分别与IL-37行相关性分析,从相关分析图中选择出具有相关性的两变量,得出患者ALT与IL-37无相关性(P0.05);而PTA与IL-37水平存在正相关性(r=0.862,P0.05)。结论:本研究发现慢性重型肝炎合并细菌感染患者血清PCT、CRP水平显著高于未合并细菌感染患者;血清PCT、CRP、IL-37水平变化可作为重型肝炎合并感染患者预后的评估指标,尤其是PCT与IL-37的变化趋势,PCT变化趋势与细菌感染是否得到有效控制有关,而IL-37变化趋势与体内炎症反应水平有关,IL-37与ALT无显著相关性,而与PTA正相关。
[Abstract]:Objective: to detect the level of serum procalcitonin (PCT), CRP,IL-37) in patients with chronic severe hepatitis and bacterial infection, and to detect the level of PCT,CRP,IL-37 in early detection of bacterial infection. Continuous monitoring of its level to predict the prognosis of chronic severe hepatitis, to explore its role in the severe hepatitis B virus infection. Methods: from December 2012 to October 2014, 30 patients with chronic severe hepatitis B complicated with bacterial infection and 30 patients with chronic severe hepatitis B were selected as observation group and 30 patients as control group. The serum levels of PCT,CRP,IL-37 in the observation group and control group before admission were detected and compared. The observation group was divided into two groups: improvement group (n = 12) and disease progression group (n = 18). Serum PCT,CRP,IL-37 levels were measured before admission, 7 days after anti-infection treatment and 14 days after treatment. The relationship between PCT,CRP,IL-37 level and prognosis was analyzed. The correlation between liver function ALT,PTA and IL-37 in patients with chronic severe hepatitis B complicated with bacterial infection was observed. Results: 1. The levels of serum PCT, CRP and IL-37 in the observation group were significantly higher than those in the control group before treatment (P0.05). After 14 days of treatment, the difference of CRP was small (P0.05), but there was no statistical significance. The CRP of the disease progression group was higher than that of the improvement group on the 7th day, the difference was statistically significant (P0.05). Compared with each time period, the CRP level in the progressive group increased first and then decreased (F5. 872% P0. 032), while in the improved group it decreased slowly (F3. 529, P0. 041). 3. The disease progression group was treated for 7 days. The level of PCT was significantly higher in 14 days than that in the improved group (P0.05). Compared with the control group, the PCT level of the disease progression group was significantly increased (F _ (24.864) P ~ (0. 001), while that of the improvement group was decreased after 7 days of treatment (F _ (4.247) P ~ (0. 037), and the disease progression group (n = 7) was treated for 7 days. The level of IL-37 was significantly lower in 14 days than that in the improvement group (P0.05). Compared with each time period, the IL-37 level of the disease progression group decreased significantly (F = 6.852, P < 0.014), while the improvement group showed an increasing trend (F = 9.125, P < 0.021). 5. The ALT, of patients with chronic severe hepatitis complicated with bacterial infection was found to be significantly lower than that of the control group (P < 0.05), while that of the improvement group was higher than that of the control group (P < 0.05). The correlation analysis between PTA and IL-37 was carried out, and two variables with correlation were selected from the correlation analysis diagram. The results showed that there was no correlation between ALT and IL-37 (P0.05). There was a positive correlation between PTA and IL-37 (P 0.05). Conclusion: the level of serum PCT,CRP in patients with chronic severe hepatitis complicated with bacterial infection was significantly higher than that in patients without bacterial infection. The change of serum PCT,CRP,IL-37 level can be used as a prognostic index in patients with severe hepatitis complicated with infection, especially the change trend of PCT and IL-37. The change trend of PCT is related to whether bacterial infection is effectively controlled. The change trend of IL-37 was related to the level of inflammatory response in vivo, IL-37 and ALT were not significantly correlated, but positively correlated with PTA.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.62
本文编号：2304189
[Abstract]:Objective: to detect the level of serum procalcitonin (PCT), CRP,IL-37) in patients with chronic severe hepatitis and bacterial infection, and to detect the level of PCT,CRP,IL-37 in early detection of bacterial infection. Continuous monitoring of its level to predict the prognosis of chronic severe hepatitis, to explore its role in the severe hepatitis B virus infection. Methods: from December 2012 to October 2014, 30 patients with chronic severe hepatitis B complicated with bacterial infection and 30 patients with chronic severe hepatitis B were selected as observation group and 30 patients as control group. The serum levels of PCT,CRP,IL-37 in the observation group and control group before admission were detected and compared. The observation group was divided into two groups: improvement group (n = 12) and disease progression group (n = 18). Serum PCT,CRP,IL-37 levels were measured before admission, 7 days after anti-infection treatment and 14 days after treatment. The relationship between PCT,CRP,IL-37 level and prognosis was analyzed. The correlation between liver function ALT,PTA and IL-37 in patients with chronic severe hepatitis B complicated with bacterial infection was observed. Results: 1. The levels of serum PCT, CRP and IL-37 in the observation group were significantly higher than those in the control group before treatment (P0.05). After 14 days of treatment, the difference of CRP was small (P0.05), but there was no statistical significance. The CRP of the disease progression group was higher than that of the improvement group on the 7th day, the difference was statistically significant (P0.05). Compared with each time period, the CRP level in the progressive group increased first and then decreased (F5. 872% P0. 032), while in the improved group it decreased slowly (F3. 529, P0. 041). 3. The disease progression group was treated for 7 days. The level of PCT was significantly higher in 14 days than that in the improved group (P0.05). Compared with the control group, the PCT level of the disease progression group was significantly increased (F _ (24.864) P ~ (0. 001), while that of the improvement group was decreased after 7 days of treatment (F _ (4.247) P ~ (0. 037), and the disease progression group (n = 7) was treated for 7 days. The level of IL-37 was significantly lower in 14 days than that in the improvement group (P0.05). Compared with each time period, the IL-37 level of the disease progression group decreased significantly (F = 6.852, P < 0.014), while the improvement group showed an increasing trend (F = 9.125, P < 0.021). 5. The ALT, of patients with chronic severe hepatitis complicated with bacterial infection was found to be significantly lower than that of the control group (P < 0.05), while that of the improvement group was higher than that of the control group (P < 0.05). The correlation analysis between PTA and IL-37 was carried out, and two variables with correlation were selected from the correlation analysis diagram. The results showed that there was no correlation between ALT and IL-37 (P0.05). There was a positive correlation between PTA and IL-37 (P 0.05). Conclusion: the level of serum PCT,CRP in patients with chronic severe hepatitis complicated with bacterial infection was significantly higher than that in patients without bacterial infection. The change of serum PCT,CRP,IL-37 level can be used as a prognostic index in patients with severe hepatitis complicated with infection, especially the change trend of PCT and IL-37. The change trend of PCT is related to whether bacterial infection is effectively controlled. The change trend of IL-37 was related to the level of inflammatory response in vivo, IL-37 and ALT were not significantly correlated, but positively correlated with PTA.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.62
【参考文献】
相关期刊论文 前10条
1 何平;张小丽;周夏袷;曾波;田文广;;肝硬化患者腹水感染与血清降钙素原的相关性分析[J];中华医院感染学杂志;2016年13期
2 刘建涛;张旭;;替比夫定辅助治疗对乙型肝炎肝硬化患者血清IL-18、IL-12、IL-37及TNF-α水平的影响[J];中国生化药物杂志;2015年11期
3 杨发成;;肝硬化失代偿并发不典型腹水自发性感染的临床分析[J];中国医药导刊;2015年10期
4 李福亮;姚丽莎;;拉米夫定联合糖皮质激素治疗慢性重型乙型肝炎临床分析[J];海南医学;2015年19期
5 刘天保;;慢性重型乙型病毒性肝炎应用恩替卡韦治疗的效果初评[J];中国继续医学教育;2015年23期
6 龚娇;代航;胡波;;乙型肝炎患者外周血中性粒细胞与淋巴细胞比值、红细胞分布宽度变化及意义[J];山东医药;2015年35期
7 胡飘萍;吴承高;李松;邹娟;肖昆;乐爱平;;预防性输注新鲜冰冻血浆对纠正慢性重型乙型病毒性肝炎患者凝血功能效果探析[J];中国输血杂志;2015年08期
8 刘建纯;王新明;;血清IL-1、sIL-2R检测在乙型病毒性肝炎病情监测中的意义[J];现代诊断与治疗;2015年16期
9 李保君;李凯杰;;恩替卡韦治疗慢性重型肝炎疗效观察[J];海南医学院学报;2015年10期
10 刘小兵;吴群;;恩替卡韦治疗慢性重型乙型肝炎疗效观察[J];中国社区医师;2015年11期
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