Diagnostic value of serum interleukin-17 combined with procalcitonin in the pulmonary bacterial infection combined with decompensation period of cirrhosis

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Author: Dan PANG Xiao-Hu ZHANG Ping ZHAO Cheng-Guo YAN  Xi-Zeng ZHU

Affiliation: Department of Infectious Diseases, Nanyang Central Hospital, Nanyang 473000, Henan Province, China

Keywords: Decompensation period of cirrhosis Interleukin-17 Procalcitonin Pulmonary infection

DOI: 10.12173/j.issn.1004-4337.202301058

Reference: Pang D, Zhang XH, Zhao P, Yan CG, Zhu XZ. Diagnostic value of serum interleukin-17 combined with procalcitonin in the pulmonary bacterial infection combined with decompensation period of cirrhosis[J]. Journal of Mathematical Medicine, 2023, 36(8): 626-631. DOI: 10.12173/j.issn.1004-4337.202301058[Article in Chinese]  Copied

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Abstract

Objective To investigate the clinical value of serum interleukin-17 (IL^-17) combined with procalcitonin in the diagnosis of pulmonary bacterial infection with decompensation period of cirrhosis.

Methods A total of 143 patients with decompensation period of cirrhosis in the department of infectious diseases, Nanyang Central Hospital between January 2022 to June 2022 were enrolled and divided into infection group (n=62) and non-infection group (n=81). The difference of clinical baseline data and serum IL^-17 expression level between the two groups were compared. Logistic regression analysis was used to analyze the influencing factors of pulmonary bacterial infection in patients with decompensation period of cirrhosis. ROC curve was used to analyze the diagnostic value of serum interleukin-17 combined with procalcitonin in the incidence of pulmonary bacterial infection in patients with decompensation period of cirrhosis.

Results Compared with the non-infection group, the levels of WBC (P<0.001), N (P<0.001), hs-CRP (P<0.001), PCT (P<0.001), PT (P<0.001), APTT (P<0.001), INR (P=0.006) significantly increased, while the level of ALB significantly decreased (P<0.001). The serum levels of IL^-17 in the non-infection group and the infection group were (48.18±10.23) ng/mL and (102.33±14.82) ng/mL, respectively. The serum levels of IL^-17 in infection group significantly increased (P<0.001). Multivariate Logistic regression analysis showed that PCT (OR=1.321) and IL^-17 (OR=1.791) were independent risk factors for pulmonary bacterial infection in patients with decompensation period of cirrhosis. The AUC of IL^-17 in the diagnosis of pulmonary bacterial infection in patients with decompensation period of cirrhosis was 0.891, the diagnostic sensitivity and specificity were 87.12% and 89.45%, respectively. The AUC of PCT was 0.862, the diagnostic sensitivity and specificity were 86.12% and 85.67%, respectively. The AUC of IL^-17 combined with PCT was 0.932, the diagnostic sensitivity and specificity were 90.13% and 91.452%, respectively.

Conclusion The serum IL^-17 levels were significantly higher expressed in patients with decompensation period of cirrhosis complicated with pulmonary bacterial infection. The IL^-17 combined with PCT has a good clinical efficacy in the diagnosis of decompensation period of cirrhosis complicated with pulmonary bacterial infection.

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1.赵倩, 赵彩彦. 肝硬化合并肺部感染诊治的难点与策略[J]. 中国临床医生杂志, 2022, 50(2): 130-133. [Zhao Q, Zhao CY. Difficulties and strategies in diagnosis and treatment of liver cirrhosis complicated with pulmonary infection[J]. Chinese Journal for Clinicians, 2022, 50(2): 130-133.] DOI: 10.3969/j.issn.2095-8552.2022.02.002.

2.张天. 124例慢性肝硬化失代偿期患者感染病原菌特点及危险因素[J]. 中国真菌学杂志, 2018, 13(4): 235-238. [Zhang T. Pathogenic bacteria and risk factors of 124 patients with decompensated chronic cirrhosis[J]. Chinese Journal of Mycology, 2018, 13(4): 235-238.] DOI: 10.3969/j.issn.1673-3827.2018.04.009.

3.刘小丽, 黄帅, 黎钟山. 失代偿期肝硬化并感染性休克患者住院死亡的危险因素分析[J]. 现代消化及介入诊疗, 2020, 25(12): 1619-1623. [Liu XL, Huang S, Li ZS. Risk factors of in-hospital death in patients with decompensated cirrhosis and septic shock[J]. Modern Digestion & Intervention, 2020, 25(12): 1619-1623.] DOI: 10.3969/j.issn.1672-2159.2020.12.014.

4.王丽, 王鹏, 尚娟. 失代偿期肝硬化患者血清降钙素原和前列腺素E2水平变化与感染的关系研究[J]. 实用预防医学, 2017, 24(11): 1388-1390. [Wang L, Wang P, Shang J. Relationship between serum procalcitonin, prostaglandin E2 levels and infection in patients with decompensated cirrhosis[J]. Practical Preventive Medicine, 2017, 24(11): 1388-1390.] DOI: 10.3969/j.issn.1006-3110.2017.11.032.

5.赖艳红, 胡韬, 毛华云. C-反应蛋白、降钙素原对肝硬化失代偿期合并肺炎患者诊断中的意义[J]. 吉林医学, 2020, 41(11): 2744-2746. [Lai YH, Hu T, Mao HY. Significance of C-reactive protein and procalcitonin in diagnosis of decompensated cirrhosis with pneumonia[J]. Jilin Medical Journal, 2020, 41(11): 2744-2746.] DOI: 10.3969/j.issn.1004-0412.2020.11.078.

6.Kumar R, Theiss AL, Venuprasad K. RORγt protein modifications and IL-17-mediated inflammation[J]. Trends Immunol, 2021, 42(11): 1037-1050. DOI: 10.1016/j.it.2021.09.005.

7.吕亚兰, 冼朝丽. 血清AFU、IL-17、CRP在乙型病毒性肝炎患者中的检测价值研究[J]. 中国处方药, 2020, 18(6): 135-136. [Lyu YL, Xian CL. Study on the detection value of serum AFU, IL-17 and CRP in patients with viral hepatitis B[J]. Journal of China Prescription Drug, 2020, 18(6): 135-136.] DOI: 10.3969/j.issn.1671-945X.2020.06.076.

8.张笛, 李贞茂, 王治兰, 等. 不同抗病毒药物治疗前后乙肝肝硬化失代偿期患者血清IL-17的观察[J]. 四川医学, 2019, 40(10): 990-992. [Zhang D, Li ZM, Wang ZL, et al. An observation of serum interleukin-17 before and after treatment of different antiviral drugs in patients with decompensated hepatitis B cirrhosis[J]. Sichuan Medical Journal, 2019, 40(10): 990-992.] DOI: 10.16252/j.cnki.issn1004-0501-2019.10.003.

9.中华医学会肝病学分会. 肝硬化诊治指南[J]. 中华肝脏病杂志, 2019, 27(11): 846-865. [Hepatology Branch of Chinese Medical Association. Chinese guidelines on the management of liver cirrhosis[J]. Chinese Journal of Hepatology, 2019, 27(11): 846-865.] DOI: 10.3760/cma.j.issn.1007-3418.2019.11.008.

10.中华医学会呼吸病学分会. 中国成人社区获得性肺炎诊断和治疗指南(2016年版)[J]. 中华结核和呼吸杂志, 2016, 39(4): 253-279. [Respiratory Branch of Chinese Medical Association. Guidelines for the diagnosis and treatment of adult community acquired pneumonia in China (2016 Edition)[J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2016, 39(4): 253-279.] DOI: 10.3760/cma.j.issn.1001-0939.2016.04.005.

11.柳梅, 时永红, 郇娟, 等. 失代偿期肝硬化患者并发医院内感染病原菌类别及其耐药特点分析[J]. 实用肝脏病杂志, 2021, 24(6): 863-866. [Liu M, Shi YH, Huan J, et al. Prevalence of nosocomial infection and resistance of pathogens in patients with decompensated liver cirrhosis[J]. Journal of Practical Hepatology, 2021, 24(6): 863-866.] DOI: 10.3969/j.issn.1672-5069.2021.06.024.

12.王宏强, 李静, 汪靖园, 等. 血清IL-6、hs-CRP、HSP70预测肝硬化并发肺部感染的价值[J]. 临床医学研究与实践, 2022, 7(19): 28-31. [Wang HQ, Li J, Wang JY, et al. The value of serum IL-6, hs-CRP and HSP70 predicting liver cirrhosis complicated with pulmonary infection[J]. Clinical Research and Practice, 2022, 7(19): 28-31.] DOI: 10.19347/j.cnki.2096-1413.202219007.

13.苏娟, 石岳飞, 张惠林. 肝硬化并肺部感染患者血清PCT、CRP、WBC的表达水平及临床意义[J]. 贵州医药, 2022, 46(1): 29-30. [Su J, Shi YF, Zhang HL. Expression levels of serum PCT, CRP and WBC in patients with liver cirrhosis and pulmonary infection and their clinical significance[J]. Guizhou Medical Journal, 2022, 46(1): 29-30.] DOI: 10.3969/j.issn.1000-744X.2022.01.010.

14.王耀辉, 张英, 朱建芸, 等. 血清降钙素原及中性粒细胞百分比对肝硬化失代偿期合并细菌感染的早期诊断价值[J]. 中山大学学报(医学科学版), 2018, 39(3): 413-419. [Wang YH, Zhang Y, Zhu JY, et al. Value of serum procalcitonin and percentage of neutrophils in early diagnosis of bacterial infection in decompensated liver cirrhosis[J]. Journal of Sun Yat-sen University (Medical Sciences), 2018, 39(3): 413-419.] DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2018.0063.

15.薛昭, 张卓红. 肺癌新辅助化疗患者血清C-反应蛋白、降钙素原和细胞角蛋白19片段抗原表达与肺部感染严重程度评分关系[J]. 陕西医学杂志, 2022, 51(10): 1227-1231. [Xue Z, Zhang ZH. Correlation between expression levels of serum CRP, PCT, CYFRA21-1 and severity score of pulmonary infection in patients with lung cancer undergoing neoadjuvant chemotherapy[J]. Shaanxi Medical Journal, 2022, 51(10): 1227-1231.] DOI: 10.3969/j.issn.1000-7377.2022.10.012.

16.杨玉香, 杜菲, 强丽, 等. 基于血清降钙素原与炎症指标建立肝硬化失代偿期患者细菌感染的诊断模型[J]. 四川医学, 2022, 43(6): 561-567. [Yang YX, Du F, Qiang L, et al. Establishment of a diagnostic model of bacterial infection in patients with decompensated liver cirrhosis based on serum procalcitonin and inflammatory indexes[J]. Sichuan Medical Journal, 2022, 43(6): 561-567.] DOI: 10.16252/j.cnki.issn1004-0501-2022.06.008.

17.McGeachy MJ, Cua DJ, Gaffen SL. The IL-17 family of cytokines in health and disease[J]. Immunity, 2019, 50(4): 892-906. DOI: 10.1016/j.immuni.2019.03.021.