Expressions of C-reactive protein, procalcitonin and interleukin-6 in bronchoalveolar lavage fluid and serum of patients with chronic obstructive pulmonary disease undergoing mechanical ventilation and their clinical significance
10.3760/cma.j.cn101721-20240229-00055
- VernacularTitle:慢性阻塞性肺疾病机械通气患者肺泡灌洗液和血清C反应蛋白、降钙素原、白细胞介素6表达及其临床意义
- Author:
Zhuo WEI
1
;
Fei YANG
;
Bei GAO
;
Peng CHEN
;
Xiaoyu CAI
Author Information
1. 成都市第三人民医院呼吸与危重症医学科，成都 610000
- Keywords:
Chronic obstructive pulmonary disease;
Mechanical ventilation;
Bronchoalveolar lavage fluid;
C-reactive protein;
Procalcitonin;
Interleukin6
- From:
Clinical Medicine of China
2024;40(4):277-282
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the expressions of bronchoalveolar lavage fluid(BALF), C-reactive protein (C reactive protein, CRP), procalcitonin (PCT) and Interleukin 6 (IL-6) in mechanically ventilated patients with chronic obstructive pulmonary diseases (COPD) and their clinical significance.Methods:A total of 128 COPD patients with mechanical ventilation admitted to the Third People's Hospital of Chengdu from September 2022 to September 2023 were selected as the study subjects. They were divided into VAP group and non-VAP group according to the occurrence of ventilator associated pneumonia (VAP). Comparison of general data between the two groups, measurement data in line with normal distribution were expressed xˉ± s, and independent sample t test was used to compare the mean between groups. Enumeration data were expressed as constituent ratio, and χ2 test was used to compare between groups. Multivariate Cox regression was used to analyze the influencing factors of VAP in COPD patients. The diagnostic value of CRP, procalcitonin and IL-6 in BALF and serum for VAP was evaluated by receiver operating characteristic (ROC) curve. Results:There were 32 cases of VAP and 96 cases of non-VAP in 128 COPD patients with mechanical ventilation. In the VAP group, the duration of mechanical ventilation was (5.12±0.48) days, and 13 patients (40.63%) had used antibiotics within 3 months, while in the non-VAP group, the duration of mechanical ventilation was (4.79±0.69) days, and 56 patients (61.46%) had used antibiotics within 3 months, respectively. There were significant differences between the two groups ( t=2.51, χ2=4.23, all P<0.05). The levels of CRP, procalcitonin and IL-6 in BALF of VAP group were (26.46±6.78) mg/L, (2.47±0.69) ng/L and (751.46±126.44), and in the non-VAP group, they were (20.47±6.26) mg/L, (1.12±0.32) ng/L and (447.89±68.69) μg/L, respectively. There were significant differences between the two groups ( t=4.59, 15.00, 17.18, all P<0.001). The serum levels of CRP, procalcitonin and IL-6 in VAP group were (124.78±26.32) mg/L, (10.53±2.20) ng/L and (221.69±45.46). The non-VAP group was (96.78±24.96) mg/L, (6.46±1.89) ng/L and (146.36±42.34) μg/L, respectively ( t=5.42, 10.12, 8.56; all P<0.001). Multivariate Cox regression analysis showed that mechanical ventilation time, BALF and serum CRP, procalcitonin and IL-6 were independent factors affecting the occurrence of VAP in COPD patients ( OR values were 1.578, 1.687, 1.669, 1.844,1.645, 1.775 and 1.659, respectively). 95% CI were 1.017-2.447, 1.066-2.669, 1.076-2.588, 1.148-2.963, 1.086-2.493, 1.172-2.690 and 1.084-2.538, all P<0.05). ROC curve showed that the AUC of CRP, procalcitonin and IL-6 in BALF and serum were 0.758/0.792, 0.965/0.930 and 0.977/0.900 respectively ( P values were 0.049/0.046, 0.030/0.030 and 0.021/0.033, respectively). Conclusion:The expressions of CRP, procalcitonin and IL-6 in BALF and serum of COPD patients with mechanical ventilation have high clinical diagnostic value, which can assist the diagnosis of early VAP.
