Kev Koom Tes Ntawm Interleukin-6 Qib Nrog Mob Mob Thiab Kev Tuag Hauv Cov Neeg Mob Nrog Coronavirus 2019 (COVID-19)
Mar 13, 2022
Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791
Jiali Zhout, Wenbo Het', Jingyu Liang, Lang Wang, Xiaomei Yu, Mingwei Bao, thiab Huafen Liu *
Department of Cardiology, Renmin Tsev Kho Mob ntawm Wuhan University, Wuhan, Tib Neeg Lub Tebchaws ntawm Tuam Tshoj
TSEEM CEEB: Tus nqi prognostic ntawm interleukin-6(IL-6) nyob rau hauvkhaus laus nas vais lavkab mob2019 (COVID-19) yuav tsum tau qhia meej. Hauv qhov kev tshawb nrhiav rov qab no, COVID-19 cov neeg mob tau kho hauv Tsev Kho Mob Renmin ntawm Wuhan University txij lub Ib Hlis 7 txog Lub Ob Hlis 8. 2020 nrog kev ntsuas cov ntshav IL-6 qib hauv 1 lub lis piam tom qab tau suav nrog. Cov ntaub ntawv hais txog cov pej xeem, cov yam ntxwv ntawm kev kho mob, kev sim kuaj mob, kev nyuaj1ons.and cov txiaj ntsig tau raug sau thiab tshuaj xyuas S1xty-s1x cov neeg mob d1 kuaj pom nrog COVID-19 tau suav nrog hauv txoj kev tshawb no (31 tus neeg mob yog poj niam). Lawv tau muab faib ua ib pab pawg (cov ntshav IL-6<10 pg/ml,="" n="35)and" an="" abnormal="" group="" (serum=""><10 pg/ml,="" n="31)." compared="" with="" the="" normal="" group,="" the="" incidence="" of="" critical="" cases=""><0.001), acute="" respiratory="" distress="" syndrome(ards)(p="0.001)," acute="" cardiac="" injury="" (p="0.002)," cardiac="" insufficiency="" (p="0.039)," mechanical="" ventilation="" rate(p="0.002)," and="" mortality="" (p="0.021)" was="" significantly="" increased="" in="" the="" abnormal="" group.="" serum="" il-6="" concentration="" was="" an="" independent="" predictor="" of="" fatal="" outcomes="" (p="0.04)." the="" optimal="" cutoff="" value="" of="" serum="" il-6="" concentration="" for="" predicting="" fatal="" outcomes="" was="" 26.09=""><0.001). in="" covid-19,="" elevated="" serum="" il-6="" levels="" were="" associated="" with="" critical="" illness,="" use="" of="" mechanical="" ventilation="" and="" complications,="" including="" heart="" injury="" and="" ards.and="" could="" predict="" a="" fatal="" outcome.="" early="" detection="" of="" serum="" il-6="" levels="" after="" admission="" should="" be="" necessary="" for="" covid-19="">
Taw qhia
Khaus laus nas vais lavkab mob2019(COVID-19) tshwm sim los ntawm tus mob hnyav ua pa nyuaj ua pa mob coronavirus 2(SARS-CoV-2) tshwm sim thaum lub Kaum Ob Hlis 2019 thiab tau dhau los ua kev hem thawj rau kev noj qab haus huv thoob ntiaj teb (1). Raws li lub Kaum Hlis, 16.2020,39.023,292 tus neeg mob tau kis tus kabmob, thiab 1.099,586 tus neeg tuag tau tshaj tawm thoob ntiaj teb (2). Cov kev tshawb fawb yav dhau los ntawm SARS tau qhia tias ntau yam cuam tshuam rau cov kab mobkhaus laus nas vais lavkev kis kab mob, xws li titers ntawm tus kab mob kis, tiv thaiv tus tswv tsev, thiab induction ntawm cytokines (3). Nws tau raug pom zoo tias lub cev tsis muaj zog tiv thaiv kab mob ua ke nrog cytokine cua daj cua dub yog koom nrog hauv cov kab mob ntawm tib neeg.khaus laus nas vais lavkab mob, xws li SARS thiab Middle East respiratory syndrome (3). Txoj kev tshawb fawb yav tom ntej ntawm SARS tau qhia tias kev nce qib ntawm SARS cuam tshuam nrog cov lus teb ntawm cov tshuaj tiv thaiv kab mob, tsis yog kev tiv thaiv kab mob (4). Kev nce qib ntawm chemokines thiab cytokines, xws li interleukin-6(IL-6), tau kuaj pom hauv cov neeg mob SARS (5). Qhov nce hauv cov ntshav chemokine / cytokine qib yog los ntawm lawv cov lus qhia siab hauv cov ntaub so ntswg (6). Cov ntaub ntawv pov thawj tsis ntev los no los ntawm kev kuaj mob autopsies tau qhia txog kev koom tes ntawm tus tswv tsev tsis muaj zog tiv thaiv kab mob thiab inflammatory cytokine cua daj cua dub hauv alveolar gas exchange puas tsuaj (7). Txij li cov chemokines / cytokines tau koom nrog hauv chemotaxis thiab ua kom cov neutrophils thiab monocytes (8), uas tuaj yeem ua rau muaj kev puas tsuaj rau lub hom phiaj hauv nruab nrog cev, xws li lub ntsws, qib ntawm cov chemokines / cytokines tuaj yeem cuam tshuam txog qhov mob hnyav. . IL-6 yog tus nruab nrab nruab nrab ntawm txoj kev inflammatory (9,10) thiab cuam tshuam nrog ob qho tib si lub cev tiv thaiv kab mob thiab mob ntev (11,12). IL-6 tuaj yeem siv los ua tus lej cim ntawm cov kab mob o (13) thiab tau siv rau kev ntsuas kev ntsuas (14). Txoj kev tshawb no tsom mus tshawb xyuas kev koom tes ntawm IL-6 qib nrog kev mob thiab kev tuag ntawm cov neeg mob nrog COVID-19, uas tuaj yeem muab pov thawj rau kev siv hluav taws xob ntawm IL-6 hauv kev pheej hmoo stratification thiab kev txiav txim siab kho mob.
PARTICIPANTS THIAB MUAB
Kawm tsim qauv thiab cov neeg koom nrog: Hauv qhov kev rov qab los no. txoj kev tshawb fawb ib leeg, peb tau tshuaj xyuas tag nrho cov xwm txheej uas tau lees paub ntawm COVID-19 tau lees paub txij lub Ib Hlis 7 txog rau Lub Ob Hlis 8, 2020, ntawm lub tsev kho mob cais ntawm Renmin (Wuhan University, Wuhan, Suav). Txhua tus neeg mob cuv npe tau kuaj pom raws li cov lus qhia ib ntus rau cov kab mob coronavirus tshiab uas tau luam tawm los ntawm National Health Commission ntawm Cov Neeg Sawv Cev ntawm Tuam Tshoj (15).
Feem ntau, cov ntaub ntawv pov thawj tau kuaj pom raws li keeb kwm kev kis kab mob (piv txwv li, kev sib kis ntawm pawg), cov tsos mob tshwm sim (ua npaws thiab / lossis cov tsos mob ua pa, kev kuaj pom lub ntsws, qhov qub lossis txo qis ntawm cov qe ntshav dawb thiab lymphocytes thaum ntxov ntawm cov kab mob pib), thiab pathogenic lossis serological pov thawj rau SARS-CoV-2 kab mob (SARS-CoV-2 nucleic acid detection and serum-specific antibodies). Cov txheej txheem kuaj mob ntawm cov neeg mob xav tias yog: cov neeg mob uas muaj keeb kwm muaj kabmob sib kis thiab 2 ntawm 3 qhov kev kuaj mob tshwm sim, lossis cov tib neeg uas muaj tag nrho 3 qhov kev kuaj mob tshwm sim thaum tsis muaj keeb kwm kis kabmob. Cov neeg mob uas xav tias muaj tus kab mob COVID-19 nrog rau kev kuaj pom zoo nucleic acid lossis cov tshuaj tiv thaiv kab mob tshwj xeeb tau kuaj pom tias yog kis mob. Tsuas yog cov neeg mob uas ntsuas cov ntshav IL-6 qib hauv thawj lub lim tiam tom qab nkag mus. Raws li cov xwm txheej tau tshaj tawm los ntawm World Health Organization-China Joint Mission on COVID-19(16), cov neeg mob tau muab faib ua 4 pawg: me (lab-pom zoo, tsis muaj mob ntsws), nruab nrab (lab-pom zoo thiab muaj mob ntsws. ), mob hnyav (dyspnea, ua pa zaus ntau dua lossis sib npaug li 30 / min, ntshav oxygen saturation<93 %,="" oxygen="" partial="" pressure(pao,)/oxygen="" inspiration="" fraction=""><300, and/or="" lung="" infiltrates="">50 feem pua ntawm lub ntsws nyob rau hauv 24-48 h) thiab tseem ceeb (ua pa tsis ua hauj lwm yuav tsum tau siv tshuab ua pa, poob siab lossis lwm lub cev tsis ua haujlwm uas yuav tsum tau saib xyuas hnyav). Lub PaO, / FiO, qhov piv tau tau los ntawm kev faib cov PaO, los ntawm FiO, qhia ua lej. Txoj kev tshawb no (No. WDRY2020-K032) tau pom zoo los ntawm Pawg Saib Xyuas Kev Ncaj Ncees ntawm Renmin Tsev Kho Mob ntawm Wuhan University. Sau ntawv tso cai raug zam los ntawm tib pawg neeg ua haujlwm.
Cov txheej txheem: PCR tiag tiag lub sijhawm tsom rau SARS-CoV-2 tshwj xeeb nucleic acid tau siv rau kev kuaj mob ntawm COVID-19. Serum IL-6 qib tau txiav txim los ntawm enzyme-linked immunosorbent assay raws li cov chaw tsim khoom cov lus qhia (ET Healthcare Inc., Palo Alto, CA, USA) thiab qhov ib txwm muaj yog<10 pg/ml="" based="" on="" the="" test="" manual="" and="" reagent="" description="" of="" renmin="" hospital="" of="" wuhan="" university.="" serum="" cardiac="" troponin="" i(can)levels="" were="" measured="" using="" a="" standard="" assay="" kit="" and="" siemens="" advia="" centaur="" xp="" automatic="" chemiluminescence="" immunoassay="" analyzer="" (siemens="" healthcare="" diagnostics="" [shanghai],="" walpole,="" nj,="" usa).="" n-terminal="" pro-b-type="" natriuretic="" peptide="" (nt-probnp)levels="" were="" measured="" using="" a="" cobas="" e601="" immune="" analyzer(roche="" diagnostics,="" mannheim,="" germany)="" according="" to="" the="" manufacturer's="" instructions.="" the="" patient's="" medical="" records="" were="" carefully="" reviewed="" and="" analyzed="" by3="" trained="" physicians.="" patient="" data="" regarding="" demographics,="" comorbidities,="" signs="" and="" symptoms,="" laboratory="" results,="" and="" complications="" were="" collected.="" the="" occurrence="" of="" medical="" complications="" was="" confirmed="" by="" 3="" physicians="" according="" to="" the="" following="" criteria:="" acute="" respiratory="" distress="" syndrome(ards)was="" defined="" according="" to="" the="" berlin="" definition(17);="" the="" acute="" cardiac="" injury="" was="" defined="" as="" a="" serum="" level="" of="" the="" can="" above="" the="" 99th="" percentile="" upper="" reference="" limit="" or="" new="" abnormalities="" were="" shown="" on="" electrocardiography="" and="" echocardiography(1);="" cardiac="" insufficiency="" was="" defined="" as="" an="" increased="" level="" of="" nt-probnp="" over="" the="" normal="" range="" with="" the="" presence="" of="" associated="" symptoms,="" such="" as="" dyspnea,="" orthopnea,="" and="" edema="" of="" the="" lower="" extremity;="" acute="" kidney="" injury="" was="" identified="" according="" to="" the="" kidney="" disease:="" improving="" global="" outcomes="" of="" definition="">
Cov txiaj ntsig: Cov txiaj ntsig tseem ceeb yog kev tuag thaum lub Plaub Hlis 9,2 lub hlis txij li kev nkag mus zaum kawg. Cov neeg mob uas ua tau raws li cov qauv hauv qab no tau raug tso tawm: cov tsos mob zoo dua, tsis kub taub hau tsawg kawg 3 hnub, pom pom kev nqus ntawm qhov mob hauv lub ntsws, thiab cov txiaj ntsig tsis zoo rau tsawg kawg 2 qhov kev sim sib law liag ntawm SARS-CoV-2 nucleic acid. Cov neeg mob uas tsis ua raws li cov txheej txheem tawm mus txuas ntxiv mus pw hauv tsev kho mob rau kev kho mob thiab saib xyuas.
Kev txheeb xyuas txheeb cais: Kev txheeb xyuas txheeb cais tau ua tiav siv SPSS version 26.0. Qhov normality ntawm kev hloov pauv tsis tu ncua tau sim siv Kolmogorov-Smirnov xeem. Cov neeg mob tau muab faib ua 2 pawg kev tshawb fawb (nrog rau ib txwm lossis nce qib IL-6 qib) Cov kev hloov pauv tsis tu ncua thiab categorical tau sau tseg raws li suav (feem pua) thiab nruab nrab (interquartile range), feem. Qhov sib txawv ntawm cov pab pawg tau raug sim los ntawm kev ntsuas kev xav uas siv Mann-Whitney U test thiab Chi-squared test, feem. Bivariate correlations ntawm IL-6 thiab lwm yam sib txawv tau raug soj ntsuam siv Spearman tus correlation coefficient. Univariate thiab multivariate logistic regressions tau siv los ntsuam xyuas cov koom haum ntawm IL-6 qib siab thiab cov txiaj ntsig, thiab qhov sib txawv ntawm qhov sib txawv (ORs) thiab 95 feem pua ntawm kev ntseeg siab (CIs) raug xam. Cov qauv hierarchical regression hauv qab no tau siv: Qauv 1 tsis tau kho. Qauv 2 tau hloov kho rau hnub nyoog thiab poj niam txiv neej. Qauv 3 tau hloov kho rau hnub nyoog, poj niam txiv neej, comorbidities xws li kub siab, kab mob plawv, kab mob cerebrovascular, ntshav qab zib, mob raum, thiab mob ntsws obstructive pulmonary. Qauv 4 tau hloov kho rau qhov hloov pauv hauv Model 3 ntxiv rau procalcitonin.
Tus neeg txais kev ua haujlwm yam ntxwv (ROC) nkhaus tau siv los ntsuas qhov muaj peev xwm ua rau muaj kev ntxub ntxaug (19). Qhov tseeb tshaj plaws txiav tawm tus nqi tau suav nrog Youden Performance index. Tag nrho cov theem tseem ceeb tau suav rau 2- qhov kev ntsuas tailed thiab txiav tawm qhov tseem ceeb tau teeb tsa ntawm P<>
cistanche extract tuaj yeem pab tib neeg txhim kho lawv txoj kev tiv thaiv kom tiv thaiv tus kab mob Coronavirus
TSEEM CEEB
Cov pej xeem, cov yam ntxwv kho mob, thiab kev kuaj pom: Tag nrho ntawm 66 tus neeg mob kuaj pom tus mob coronavirus tau suav nrog hauv txoj kev tshawb no. Lub hnub nyoog nruab nrab yog 63 xyoo (ntxiv 31-92 xyoo). Nyob rau hauv tag nrho, 31 tus neeg mob yog poj niam (47.0 feem pua ).Los txog lub Plaub Hlis 9, 2020,56 tus neeg mob tau tawm, 8 tus neeg mob tuag, thiab 2 tus neeg mob txuas ntxiv mus pw hauv tsev kho mob. Lub sijhawm nyob hauv tsev kho mob yog 32 (ntau 21-43) hnub. Daim duab 1 qhia tau hais tias muaj cov kab mob sib txawv xws li mob ntshav siab (24 tus neeg mob, 36.4 feem pua), ntshav qab zib (14 tus neeg mob. 21.2 feem pua), thiab kab mob plawv (1l cov neeg mob, 16.7 feem pua). Muaj 3 qhov nruab nrab, 46 mob hnyav, thiab 17 tus neeg mob hnyav. Cov neeg mob tau muab faib ua pawg siab thiab ib txwm ua raws li qhov ib txwm muaj ntawm cov ntshav lL-6 concentrations(<10 pg/ml).="" the="" median="" serum="" il-6="" concentration="" in="" the="" elevated="" group="" was="" 30.00="" pg/ml,="" while="" that="" in="" the="" normal="" group="" was="" 1.77="" pg/ml.="" compared="" with="" patients="" with="" normal="" serum="" il-6="" levels,="" patients="" with="" elevated="" serum="" il-6="" levels="" were="" older="" and="" the="" proportion="">
Association of IL-6 with Morbidity and Mortality in COVID-19
Table 1. Cov pej xeem, cov yam ntxwv kho mob, thiab kev kuaj pom
Qhov sib txawv tsis tu ncua yog qhia raws li qhov nruab nrab (IQR) thiab categorical variables yog qhia raws li suav (feem pua). SEO yog tus nqi qis tshaj plaws ntawm cov pa oxygen saturation uas tau sau tseg thaum nyob hauv tsev kho mob, IL-6 cov concentrations tau txiav txim siab nyob rau hauv 1 lub lis piam tom qab nkag mus thaum lwm qhov kev kuaj pom thiab cov cim tseem ceeb tau txais thaum nkag.
ALT, alanine aminotransferase; AST, aspartate aminotransferase; COPD, kab mob obstructive pulmonary; DBP, diastolic ntshav siab; IQR, interquartile ntau; NT-proBNP, N-terminal pro-B-hom natriuretic peptide; SBP, systolic ntshav siab.
cistanche extract tuaj yeem pab tib neeg txhim kho lawv txoj kev tiv thaiv kom tiv thaiv tus kab mob Coronavirus
cov xwm txheej tseem ceeb tau ntau dua. Lub sijhawm los ntawm qhov pib mus rau kev nkag mus rau hauv pawg neeg siab tau luv dua li ntawm pawg ib txwm muaj, thaum tsis muaj qhov sib txawv hauv tsev kho mob tau pom ntawm 2 pawg. Muaj ntau tus neeg mob nyob rau hauv cov pab pawg siab uas muaj keeb kwm ntawm cov kab mob cerebrovascular dua li cov pab pawg ib txwm muaj. Qhov qis tshaj pulse oxygen saturation (SpO,) uas tau sau tseg thaum nyob hauv tsev kho mob hauv pawg neeg siab tau qis dua li hauv pawg ib txwm muaj. Hauv kev kuaj pom ntawm kev nkag mus, cov platelet suav tau txo qis, thaum cov ntshav cov ntshav ntau ntawm creatinine, tuaj yeem, procalcitonin, thiab C-reactive protein tau nce ntau hauv cov neeg mob uas nce qib IL-6, piv rau cov neeg mob. nrog ib txwm IL-6 qib.
Kev sib raug zoo ntawm serum IL-6 concentrations thiab lwm yam txawv: Raws li pom los ntawm Spearman txoj kev sib raug zoo (Table 2), ntshav IL-6 concentrations tau zoo correlated nrog hnub nyoog, urea, creatinine, tau, NT-proBNP, C- reactive protein, thiab procalcitonin.
Kev sib raug zoo nrog IL-6 kuj pom muaj rau cov ntshav dawb suav thiab suav neutrophil. Tsis tas li ntawd, cov ntshav IL-6 cov concentrations tsis zoo cuam tshuam nrog qhov qis tshaj SpO, sau tseg thaum nyob hauv tsev kho mob, Lymphocyte suav, thiab platelet suav.
Cov teeb meem thiab cov txiaj ntsig tau tshwm sim hauv cov neeg mob uas muaj cov ntshav qab zib sib txawv IL-6 qib: Raws li tau piav qhia hauv Table 3, qhov tshwm sim tsis zoo thiab qhov tshwm sim ntau dua ntawm cov teeb meem tau pom nyob rau hauv cov neeg mob uas muaj ntshav siab IL-6 qib piv nrog cov hauv ib pab pawg. . Cov teeb meem, suav nrog kev mob plawv, mob plawv tsis txaus, thiab ARDS, tau tshwm sim ntau zaus hauv cov neeg mob uas nce qib IL-6 ntau dua li cov uas muaj qib ib txwm muaj. Hauv kev sib piv rau cov pab pawg ib txwm muaj, qhov xwm txheej ntawm cov xwm txheej tseem ceeb thiab cov neeg tuag nyob hauv pawg neeg siab tau siab dua, thiab ntau tus neeg mob hauv pawg neeg siab tau txais cov tshuab ua pa. Lub sijhawm nruab nrab ntawm kev tuag yog 3(1-37) hnub tom qab kuaj pom cov ntshav IL-6 qib hauv cov neeg tuag.
Predictive tus nqi ntawm serum IL-6 concentrations rau qhov tshwm sim: Logistic regression tsom xam rau cov koom haum ntawm cov ntshav IL-6 qib thiab cov txiaj ntsig tau pom nyob rau hauv Table 4. Univariate tsom xam (Model 1) qhia tias cov ntshav IL{{4} } qib tau cuam tshuam nrog kev mob hnyav thiab kev tuag. Tom qab hloov kho lub hnub nyoog, poj niam txiv neej, comorbidities, thiab procalcitonin (Model 4), ntshav IL-6 qib tseem nyob ntawm nws tus kheej cuam tshuam nrog kev mob hnyav. Nyob rau hauv ntau hom kev logistic regression qauv (Cov Qauv 2 txog 4), tom qab hnub nyoog, poj niam txiv neej, comorbidities,
thiab cov qib procalcitonin tau hloov kho hierarchically thiab ntshav IL {{0}} concentration tseem yog ib qho kev kwv yees ntawm qhov tshwm sim tuag. Nyob rau hauv sib piv, tsis muaj kev koom tes tseem ceeb nrog tus kab mob hnyav los yog tshwm sim tau pom rau C-reactive protein, ib tug classical o marker uas tau txiav txim siab niaj hnub. Qhov kwv yees tus nqi ntawm cov ntshav IL-6 ntau npaum li cas rau qhov tshwm sim tuag tau raug soj ntsuam ntxiv siv ROC nkhaus (Fig. 1). Tom qab kev ua kom zoo, qhov pib ntawm cov ntshav IL-6 qhov siab tshaj plaws rau kev kwv yees kev tuag yog 26. feem pua CI0.767-1.000, P<>
cistanche extract tuaj yeem pab tib neeg txhim kho lawv txoj kev tiv thaiv kom tiv thaiv tus kab mob Coronavirus
Kev sib tham
Txoj kev tshawb fawb tam sim no qhia txog kev sib raug zoo ntawm cov ntshav IL-6 qib, teeb meem, thiab cov txiaj ntsig tau tshwm sim hauv cov neeg mob COVID-19. Peb tshaj tawm 3 qhov kev tshawb pom loj hauv qhov kev tshawb fawb no. Ua ntej, cov neeg mob uas muaj ntshav siab IL-6 qib muaj qhov tshwm sim ntau dua ntawm kev mob hnyav, muaj teeb meem nrog rau kev raug mob plawv thiab ARDS, kev siv tshuab ua pa, thiab ua rau tuag taus. Qhov thib ob, ntshav IL-6 concentration tau zoo sib raug zoo nrog biomarkers rau mob plawv thiab raum. Qhov thib peb, cov ntshav siab IL-6kev sib xyaw ua ke yog ib qho kev ua haujlwm ywj pheej ntawm kev ua rau tuag taus hauv cov neeg mob nrog COVID-19. Hauv txoj kev tshawb fawb tam sim no, qib siab IL-6 qib tau cuam tshuam nrog txo qis oxygen saturation, nce kab mob hnyav, thiab nquag siv tshuab ua pa, qhia tau tias cov ntshav IL-6 tuaj yeem cuam tshuam qhov mob hnyav thiab mob ntsws. thiab tuaj yeem muaj txiaj ntsig kwv yees hauv cov neeg mob uas muaj COVID-19. Muaj ntau yam tsis txaus ntseeg cuam tshuam nrog cov ntshav IL-6 qib uas tuaj yeem cuam tshuam tus kab mob hnyav thiab qhov tshwm sim,
Association of IL-6 with Morbidity and Mortality in COVID-19
Table 4. Univariate thiab multivariate logistic regression tsom xam ntawm serum I-6 thiab
C-reactive protein rau cov txiaj ntsig
Qauv 1 yog crude (tsis kho); Qauv 2 tau hloov kho raws hnub nyoog thiab poj niam txiv neej; Qauv 3 tau hloov kho raws hnub nyoog, poj niam txiv neej, comorbidities xws li kub siab, kab mob plawv, kab mob cerebrovascular, ntshav qab zib, mob raum, thiab mob ntsws ntsws ntev; Qauv 4 tau hloov kho los ntawm kev hloov pauv hauv Model 3 ntxiv rau procalcitonin. CI, kev ntseeg siab luv; LOSSIS, odds ratio.
Fig.1. Tus neeg txais kev khiav hauj lwm yam ntxwv (ROC) nkhaus ntawm cov ntshav lL-6 concentrations rau qhov tshwm sim tuag taus. Qhov chaw nyob hauv qab qhov nkhaus yog 0.887. Qhov zoo tshaj plaws txiav tawm tus nqi raug xaiv rau qhov taw tes ntawm ROC nkhaus muaj qhov tsawg kawg nkaus nyob rau sab laug ces kaum (qhov twg rhiab heev =1 thiab qhov tshwj xeeb =1).
xws li hnub nyoog thiab kab mob. Kev sib raug zoo ntawm cov ntshav IL-6 qib thiab hnub nyoog tau pom nyob rau hauv txoj kev tshawb fawb tam sim no, thiab kev sib raug zoo zoo sib xws tau raug tshaj tawm yav dhau los hauv cov neeg mob uas tsis muaj tus kab mob sib kis (20), qhia tias muaj kev sib raug zoo ntawm lub hnub nyoog thiab qhov mob. Tsis tas li ntawd, kev nce qib IL-6 qib yuav cuam tshuam nrog cov kab mob sib kis. Ib txoj kev tshawb fawb yav dhau los ntawm kev mob ntsws tau qhia txog kev sib koom ua ke ntawm cov kab mob sib kis thiab nce ntshav IL-6 qib (21). Peb cov ntaub ntawv tseem qhia tau tias muaj kev sib raug zoo ntawm cov ntshav IL-6 qib thiab qhov ntsuas ntawm cov kab mob, xws li neutrophil suav thiab procalcitonin. Txhawm rau ntsuas qhov kev kwv yees tus nqi ywj pheej ntawm IL-6, hnub nyoog thiab qib procalcitonin tau raug kho los ntawm kev siv ntau qhov sib txawv logistic regression. Cov txiaj ntsig tau pom tias cov ntshav qab zib IL-6 concentration yog ntawm nws tus kheej cuam tshuam nrog kev mob hnyav thiab yog ib qho kev kwv yees ntawm kev ua rau tuag taus.
Serum IL-6 qib kuj tseem yuav cuam tshuam nrog cov teeb meem cuam tshuam nrog COVID-19. Peb cov ntaub ntawv tau pom muaj kev sib raug zoo ntawm IL-6 nrog rau ntau lub biomarkers rau lub raum ua haujlwm thiab mob plawv, xws li urea, creatinine, tuaj yeem, thiab NT-proBNP Raws li tau piav qhia hauv Table 3, qhov tshwm sim ntawm ntau yam teeb meem, xws li ARDS , mob plawv raug mob, thiab mob plawv tsis txaus, tau nce siab dua hauv cov neeg mob uas muaj qib ntshav siab IL-6 ntau dua li cov uas muaj IL-6 ib txwm muaj. Kev raug mob plawv hauv COVID-19 tej zaum yuav tshwm sim los ntawm ntau yam, xws li kev cuam tshuam tus kab mob thiab kab mob hauv lub cev. Nws tau raug tshaj tawm tias qhov chaw ntxeem tau ntawm SARS-coronavirus (SARS-CoV) cuam tshuam rau lub xub ntiag ntawm angiotensin-hloov enzyme 2 (ACE2) (22), uas tau nthuav tawm ntau hauv lub ntsws thiab cov hnyuv (23). ACE2 kuj qhia nyob rau hauv endothelium thiab cov leeg du ntawm vasculature hauv plawv (24). SARS-CoV RNA tau kuaj pom hauv tib neeg lub siab uas tau txais los ntawm cov neeg mob uas muaj SARS-CoV, thiab macrophage infiltration tau pom nyob rau hauv cov kab mob no (25). Txawm li cas los xij, tsis muaj pov thawj histological los txhawb qhov cuam tshuam ncaj qha ntawm SARS-CoV-2 ntawm cardiomyocytes(26). Cov kab mob hauv cov kab mob pathophysiological tuaj yeem ua rau lub plawv puas. Nws tau raug tshaj tawm tias qee cov cytokines, suav nrog IL-1, IL-4, IL-6, IL-8, thiab IL-18, uas cuam tshuam nrog mob plawv pathologies, koom nrog hauv plawv tsis ua haujlwm (27). Peb cov txiaj ntsig tseem pom muaj kev sib raug zoo ntawm IL-6 thiab mob plawv lossis mob plawv, qhia txog lub luag haujlwm ntawm kev mob plawv hauv cov neeg mob COVID-19.
The optimal cutoff value of IL-6 for mortality prediction in the present study was 26.09 pg/mL, which was similar to that reported in other studies. For instance, IL-6>25 pg/mL was reported to be an important risk factor for severe COVID-19 and/or in-hospital mortality (28). Severe complications were more likely to occur in COVID patients with IL-6levels>32.1 pg/mL raws li kev tshawb fawb pej xeem ntawm 140 tus neeg mob uas muaj kab mob me me mus rau mob hnyav (29). Tsis tas li ntawd, L-6 yog qhov muaj peev xwm biomarker rau kev loj hlob ntawm COVID-19 (30). Monoclonal antibodies tsom rau IL-6 txoj hauv kev tau siv los kho COVID-19, uas tuaj yeem thaiv cov cua daj cua dub. Piv txwv li, tocilizumab, ib qho tshuaj tiv thaiv kab mob monoclonal uas thaiv IL-6 receptors, tau qhia txog kev txhawb nqa kev kho mob hauv COVID{10}} kev kho mob (7). Kev kuaj xyuas cov ntshav IL-6 qib tom qab nkag mus yuav tsum yog qhov tsim nyog rau cov neeg mob uas muaj tus kab mob COVID{13}}, uas tuaj yeem pab txheeb xyuas cov neeg mob uas muaj kev pheej hmoo siab thiab muab kev qhia rau kev tiv thaiv kab mob tiv thaiv kab mob.
Raws li kev tshawb fawb rov qab txog cov kab mob hnyav, IL-6 tsis tau txiav txim siab niaj hnub rau txhua tus neeg mob. Tsuas yog ib feem me me ntawm cov neeg mob tau txais kev ntsuas ntawm IL-6 hauv thawj lub lim tiam tom qab nkag, thiab feem ntau ntawm kev ntsuas tsis tau ua thaum nkag. Serum IL-6 qib tau txiav txim siab nyob rau hauv thawj lub lim tiam tom qab tau txais kev tso npe siv rau kev tshuaj xyuas. Tsis tas li ntawd, lwm cov cytokines tseem ceeb koom nrog hauv kev mob plab xws li IL-10 tsis tau txiav txim siab tib lub sijhawm.
Hauv kev xaus, hauv cov neeg mob uas muaj tus kab mob COVID-19, qib siab IL-6 qib tau cuam tshuam nrog kev mob hnyav, kev siv tshuab ua pa, thiab muaj teeb meem nrog rau kev raug mob plawv thiab ARDS. Serum IL -6 concentration yog ib qho kev ywj pheej kwv yees ntawm qhov tshwm sim tuag. Qhov zoo tshaj plaws txiav tawm tus nqi ntawm IL-6 rau kev kwv yees kev tuag yog 26.09 ng / mL. Peb txoj kev tshawb fawb qhia tias kev tshawb pom cov ntshav IL-6 qib tom qab nkag yuav tsum tsim nyog rau cov neeg mob COVID-19.
Kev lees paub Txoj haujlwm no tau txais kev txhawb nqa los ntawm National Natural Science Foundation ntawm Tuam Tshoj (tus lej nyiaj 81570450, 81900455).
Kev tsis sib haum xeeb Tsis muaj los tshaj tawm.
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