血清降鈣素原、CRP與IL-37水平變化在慢性重型乙型肝炎并細(xì)菌感染的作用
發(fā)布時間：2018-11-01 14:23
【摘要】：目的:通過監(jiān)測慢性重型肝炎并細(xì)菌感染血清降鈣素原(PCT)、CRP、IL-37在治療中水平變化,聯(lián)合檢測PCT、CRP、IL-37水平早期發(fā)現(xiàn)細(xì)菌感染,持續(xù)監(jiān)測其水平變化預(yù)測慢性重型肝炎的預(yù)后,探討其在乙肝病毒感染重癥化的作用。方法:選擇2012年12月至2014年10月來南昌大學(xué)第一附屬醫(yī)院感染科住院的慢性重型乙型肝炎合并細(xì)菌感染患者30例作為觀察組;選取30例慢性重型乙型肝炎為對照組。檢測比較入院前觀察組、對照組血清PCT、CRP、IL-37水平。將觀察組分為好轉(zhuǎn)組(12例)和疾病進(jìn)展組(18例),檢測入院前、抗感染治療7天、治療14天血清PCT、CRP、IL-37水平,分析PCT、CRP、IL-37水平與預(yù)后的關(guān)系,并觀察慢性重型乙型肝炎合并細(xì)菌感染的肝功能ALT、PTA與IL-37水平是否存在相關(guān)性。結(jié)果:1、觀察組治療前血清PCT水平、CRP水平、IL-37水平明顯高于對照組,差異具有統(tǒng)計學(xué)意義(P0.05)。2、疾病進(jìn)展組和好轉(zhuǎn)組治療前、治療14天的CRP差異較小(P0.05),無統(tǒng)計學(xué)意義.,疾病進(jìn)展組CRP治療7天時高于好轉(zhuǎn)組,差異具有統(tǒng)計學(xué)意義(P0.05)。組內(nèi)不同時間段比較,疾病進(jìn)展組CRP水平呈先上升后下降趨勢(F=5.872,P=0.032),而好轉(zhuǎn)組則呈緩慢下降趨勢(F=3.529,P=0.041)。3、疾病進(jìn)展組治療7天、14天時PCT水平均不同程度明顯高于好轉(zhuǎn)組,差異具有統(tǒng)計學(xué)意義(P0.05)。組內(nèi)不同時間段比較,疾病進(jìn)展組PCT水平呈顯著上升趨勢(F=24.864,P=0.001),而好轉(zhuǎn)組則在治療7天后呈下降趨勢(F=4.247,P=0.037)。4、疾病進(jìn)展組治療7天、14天時IL-37水平均不同程度明顯低于好轉(zhuǎn)組,差異具有統(tǒng)計學(xué)意義(P0.05)。組內(nèi)不同時間段比較,疾病進(jìn)展組IL-37水平呈顯著下降趨勢(F=6.852,P=0.014),而好轉(zhuǎn)組則呈上升趨勢(F=9.125,P=0.021)。5、將慢性重型肝炎合并細(xì)菌感染患者的ALT、PTA分別與IL-37行相關(guān)性分析,從相關(guān)分析圖中選擇出具有相關(guān)性的兩變量,得出患者ALT與IL-37無相關(guān)性(P0.05);而PTA與IL-37水平存在正相關(guān)性(r=0.862,P0.05)。結(jié)論:本研究發(fā)現(xiàn)慢性重型肝炎合并細(xì)菌感染患者血清PCT、CRP水平顯著高于未合并細(xì)菌感染患者;血清PCT、CRP、IL-37水平變化可作為重型肝炎合并感染患者預(yù)后的評估指標(biāo),尤其是PCT與IL-37的變化趨勢,PCT變化趨勢與細(xì)菌感染是否得到有效控制有關(guān),而IL-37變化趨勢與體內(nèi)炎癥反應(yīng)水平有關(guān),IL-37與ALT無顯著相關(guān)性,而與PTA正相關(guān)。
[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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R512.62
本文編號：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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R512.62
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