Objective: To investigate the changes of cytokine profile in elderly patients with silicosis and lower respiratory tract infection and its clinical significance. Methods: In Oclober 2019, a retrospective study was conducted to select 167 elderly patients with silicosis from Xuzhou Mining Group General Hospital as subjects, including 115 patients with silicosis and lower respiratory tract infection as infected group, including 41 patients with stage I silicosis, 38 patients with stage II silicosis and 36 patients with stage III silicosis. There were 52 cases of silicosis without lower respiratory tract infection as non-infected group, and 48 cases of healthy examination in our hospital were selected as control group. All the participants were tested for cytokines (IL-6, IL-10, IL-17A, TNF-α, IFN-γ) and statistically analyzed the relevant experimental data. Results: The levels of IL-6, IL-10, IL-17A, TNF-α and IFN-γ in the infected group after treatment were significantly lower than those before treatment (P<0.05) . The levels of IL-6, IL-10, IL-17A, TNF-α and IFN-γ before and after treatment in the infected group were higher than those in the non-infected group and the control group (P<0.05) . The levels of IL-10, IL-17A, TNF-α and IFN-γ in the infected group were higher than those in the control group, and the difference were statistically significant (P<0.05) . The levels of IL-6, IL-10, IL-17A and IFN-γ in patients with stage III silicosis were higher than those in stage I silicosis in infected group (P<0.05) . The levels of IL-6 and IL-17A in the patients with stage Ⅲ silicosis were higher than those in the patients with stage II silicosis in infected group (P<0.05) . The level of IL-10 in patients with stage II silicosis was higher than that in stage I in infected group (P<0.05) . ROC curve analysis of the indicators for diagnosis of senile silicosis with lower respiratory tract infection and silicosis without lower respiratory tract infection found that IL-6 had the largest AUC (0.910) . And its specifuity and sensithcity were 85.2% and 98.1% respectivehy. Conclusion: The detection of cytokines such as IL-6 and IL-10 has better specificity and higher diagnostic efficiency in the early diagnosis and treatment of elderly patients with silicosis complicated with lower respiratory tract infection. It has good clinical application value and can provide important laboratory evidence for early treatment for clinicians.
目的： 探讨细胞因子谱在老年矽肺合并下呼吸道感染患者体内水平变化及其临床意义。 方法： 于2019年10月，采取回顾性研究，选取徐州矿务集团总医院收治的老年矽肺患者167例为调查对象，分为矽肺伴下呼吸道感染患者115例作为感染组，其中Ⅰ期矽肺41例，Ⅱ期矽肺38例，Ⅲ期矽肺36例；矽肺不伴下呼吸道感染患者52例作为不感染组；选择同期院内健康体检者48例作为对照组。调查对象进行细胞因子白介素6（IL-6）、白介素10（IL-10）、白介素17A（IL-17A）、肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）等指标水平检测并统计分析相关实验数据。 结果： 与治疗前比较，治疗后感染组的IL-6、IL-10、IL-17A、TNF-α和IFN-γ水平均明显降低，差异有统计学意义（P<0.05）；与不感染组和对照组比较，感染组治疗前后的IL-6、IL-10、IL-17A、TNF-α和IFN-γ水平均更高，差异有统计学意义（P<0.05）；与对照组比较，不感染组的IL-10、IL-17A、TNF-α和IFN-γ水平均更高，差异有统计学意义（P<0.05）。与感染组Ⅰ期患者比较，感染组Ⅲ期患者治疗前IL-6、IL-10、IL-17A和IFN-γ水平更高；与感染组Ⅱ期患者比较，感染组Ⅲ期患者治疗前IL-6、IL-17A水平更高；与感染组Ⅰ期患者比较，感染组Ⅱ期患者IL-10水平更高，差异均有统计学意义（P<0.05）。各指标诊断老年矽肺患者工作特征曲线（ROC）分析发现，IL-6的线下面积（AUC）最大（AUC=0.910），其特异度和敏感度分别为85.2%和98.1%。 结论： IL-6、IL-10等细胞因子检测在老年矽肺合并下呼吸道感染患者早期诊疗中具有较好的特异度及较高的诊断效能，具有较好的临床应用价值，可为临床医生早期治疗提供重要的实验室依据。.
Keywords: Cytokines; Lower respiratory tract infection; Senile; Silicosis.