Kev Koom Tes Ntawm Interleukin-6 Qib Nrog Mob Mob Thiab Kev Tuag Hauv Cov Neeg Mob Nrog Coronavirus 2019(COVD-19) Ⅱ
Apr 08, 2024
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). Hauv tag nrho 31 tus neeg mob yog poj niam (47.0 %). 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. Table 1 qhia tau hais tias muaj cov kab mob sib kisntshav siab(24 tus neeg mob, 36.4%),ntshav qab zib(14 tus neeg mob, 21.2%), thiabkab mob plawv(11 tus neeg mob, 16.7%). Muaj 3 qhov nruab nrab.46 mob hnyav, thiab 17 kis mob hnyav. Cov neeg mob tau muab cais ua pawg siab thiab ib txwm ua raws li qhov ib txwm muaj ntawm IL -6 concentrations (<10 pg/mL). The median serum l-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 of cov xwm txheej tseem ceeb tau ntau dua. Lub caij nyoog los ntawm qhov pib mus rau kev nkag mus rau hauv pawg neeg siab yog luv luv dua li hauv 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 pulseoxygen saturation (SpO,) cov ntaub ntawv sau tseg thaum nyob hauv tsev kho mob hauv pab pawg siab tau qis dua li cov pab pawg ib txwm muaj. Hauv kev kuaj pom ntawm kev nkag mus, cov platelet suav tau txo qis, thaum cov ntshav ntshav ntau ntawm creatinine, cTnl, procalcitonin, thiab C-reactive protein tau nce ntau hauv cov neeg mob uas muaj qib siab I-6, piv rau cov neeg mob. nrog ib txwm IL -6 qib.
Kev sib txheeb ntawmserum I -6 concentrationsthiab lwm yam sib txawv: Raws li pom los ntawm Spearman qhov sib txheeb (Table 2), cov ntshav IL-6 cov concentrations tau zoo sib xws nrog hnub nyoog, urea, creatinine, cTnNT-proBNP, C-reactive protein, thiab procalcitonin. Kev sib raug zoo nrog lL-6 kuj tau pom rau cov ntshav dawb suav thiab suav neutrophil. Ntxiv rau,serum IL -6 concentrationstau cuam tshuam tsis zoo nrog SpO qis tshaj plaws, tau sau tseg thaum nyob hauv tsev kho mob, suav cov lymphocytes, 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 I-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 pawg ib txwm muaj teeb meem, suav nrog mob plawv raug mob, cardacinsufficiency, thiab ARDS, tshwm sim ntau zaus hauv cov neeg mob uas muaj qib IL-6 siab dua li cov uas muaj qib ib txwm muaj. Hauv kev sib piv rau cov pab pawg ib txwm muaj, qhov tshwm sim 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 cua tshuab Lub sijhawm nruab nrab ntawm kev tuag yog 3(1-37) hnub tom qab kuaj pom ntawm serum IL-6 qib hauv cov neeg tuag. Kev kwv yees tus nqi ntawm serum I-6 concentrations rau qhov tshwm sim: Logistic regression tsom xam rau cov koom haum ntawm serum IL-6 qib thiab cov txiaj ntsig tau pom nyob rau hauv Table 4. Univariate analysis (Model 1) qhia tias ntshav qab zib -6 qib tau cuam tshuam nrog kev mob hnyav thiab kev tuag. Tom qab kho lub hnub nyoog, thiab kev sib deev. comorbidities, thiab procalcitonin (Model 4), serumIL-6 qib tseem nyob ntawm nws tus kheej cuam tshuam nrog kev mob hnyav. Hauv cov qauv kev sib txawv ntawm cov logistic regression (Cov Qauv 2 txog 4), tom qab hnub nyoog, poj niam txiv neej, comorbidities, thiab procalcitonin qib tau hloov kho hierarchically thiab ntshav.IL -6 concentrationtseem yog ib tug ywj pheej 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. qhov nkhaus 0.887.95 % CI0.767-1.{15}}.P<0.001)
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 qhov tshwm sim hauv cov neeg mob uas muajCOVID-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. Thib peb, elevated serumI-6 concentration yog ib qho kev kwv yees ntawm cov ntaub ntawv! qhov tshwm sim hauv cov neeg mob nrog COVID-19. Hauv qhov kev tshawb fawb tam sim no, qib siab IL-6 qib tau cuam tshuam nrog kev txo qis oxygen saturation, nce kab mob hnyav, thiab nquag siv cov 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 rau cov neeg mob COVID-19. Muaj ntau yam tsis meej pem cuam tshuam nrog ntshav IL-6 qib uas tuaj yeem cuam tshuam cov kab mob hnyav thiab tshwm sim 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 kab mob sib kis (20), qhia txog kev sib raug zoo ntawm lub hnub nyoog thiab qhov mob. Tsis tas li ntawd, qib nce qib IL{11}} tuaj yeem cuam tshuam nrog kev kis kab mob. 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{12}} qib (21). Peb cov ntaub ntawv tseem qhia tau tias muaj kev sib raug zoo ntawm cov ntshav ntshav I-6 qib thiab qhov ntsuas ntawm cov kab mob, xws li cov suav neutrophil thiab procalcitonin.
Txhawm rau ntsuas tus nqi kwv yees ywj pheej ntawm IL-6, hnub nyoog, thiab qib procalcitonin
tau hloov kho siv multivariate logistic regression. Cov txiaj ntsig tau pom tias cov ntshav qab zib I-6 concentration yog tus kheej muaj feem cuam tshuam nrog kev mob hnyav thiab yog tus kws tshaj lij ywj pheej ntawm qhov tshwm sim 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 tseem ceeb nrog ofIL-6 nrog ntau lub biomarkers rau lub raum ua haujlwm thiab mob plawv, xws li urea, creatinine, cTnl, thiab NT-proBNPAs tau piav qhia hauv Table 3, qhov tshwm sim ntawm ntau yam teeb meem, xws li ARDS, mob plawv mob. thiab mob plawv tsis txaus tau nce siab dua hauv cov neeg mob uas muaj qib siab ntawm cov ntshav IL-6 ntau dua li cov neeg uas muaj l-6 concentrations. 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 kev mob hauv lub cev. Nws tau raug tshaj tawm tias qhov chaw ntxeem tau ntawm SARS-coronavirus SARS-CoV) cuam tshuam nrog lub xub ntiag ntawm angiotensin-hloov enzyme 2 (ACE2) (22), uas tau nthuav tawm ntau hauv lub ntsws thiab cov hnyuv (23).ACE2 kuj tau qhia. nyob rau hauv lub endothelium thiab cov nqaij mos ntawm lub vasculature nyob rau hauv lub plawv (24).SARS.CoV RNA tau kuaj pom nyob rau hauv autopsied tib neeg lub siab tau txais los ntawm cov neeg mob uas muaj tus kab mob SARS-CoV, thiab macrophage infiltration tau soj ntsuam nyob rau hauv cov kab mob no lub plawv (25).
However, there is no histological evidence supporting the direct impairment of the SARS-CoV-2 on cardiomyocytes(26). Systemic infammation under pathophysiological conditions might also cause heart damage. It has been reported that some circulating cytokines, including IL-1,1L-4, 1L-6, 1L-8, and 1L-18which are related to inflammatory cardiac pathologies. are involved in cardiac dysfunction (27). Our results also found correlations between I-6 and cardiac injury or cardiac dysfunction, suggesting a possible role of inflammation in heart injury in COVID-19 patients. The optimal cutoff value of IL-6 for mortality prediction in the present study was 26.09 pg/which was similar to that reported in other studies. For instance,1L-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 COVlD patients with IL-6 levels >32.1pg / mL raws li kev tshawb fawb pej xeem ntawm 140 cov neeg mob uas muaj kab mob me me mus rau hnyav (29). Tsis tas li ntawd, IL-6 yog lub peev xwm biomarker rau kev nce qib 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 -6 receptors, tau qhia kev txhawb nqa kev kho mob hauv COVID-19 kev kho mob (7). Kev kuaj xyuas cov ntshav IL{12}} qib tom qab nkag mus yuav tsum tsim nyog rau cov neeg mob uas muaj tus kab mob COVID-19, 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 nrhiav rov qab rau cov kab mob hnyav 1-6 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 nyob rau lub lim tiam frst tom qab nkag, thiab feem ntau ntawm kev ntsuas tsis tau ua thaum nkag. Serum I-6 qib tau txiav txim siab nyob rau hauv lub lim tiam frst tom qab tau txais kev tso cai siv rau kev tshuaj xyuas. Tsis tas li ntawd, lwm cov cytokines tseem ceeb koom nrog hauv kev mob plab xws li lL-10 tsis tau txiav txim siab tib lub sijhawm. Hauv kev xaus, hauv cov neeg mob uas muaj COVID-19, nce qib IL{5}} qib tau cuam tshuam nrog kev mob hnyav. siv cov tshuab ua pa, thiab muaj teeb meem nrog rau kev raug mob plawv thiab ARDS. Serum concentration yog ib qho kev txiav txim siab ywj pheej ntawm qhov tshwm sim tuag taus. 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 kuaj pom cov ntshav IL-6 qib tom qab nkag mus yuav tsum tsim nyog hauv cov neeg mob COVID{10}}.
Kev lees paub Txoj haujlwm no tau txais kev txhawb nqa los ntawm National Natural Science Foundation ntawm Tuam Tshoj (tus lej nyiaj 8157045081900455).
Kev tsis sib haum xeeb Tsis muaj los tshaj tawm
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