超声参数与TLR4、KL-6的相关性及对肺炎诊断的意义

doi:10.7517/issn.1674-0475.221006

摘要/Abstract

摘要： 分析超声参数与Toll样受体4（TLR4）、涎液化糖链抗原-6（KL-6）的相关性及对肺炎的诊断价值。选取105例疑似肺炎的患者作为研究对象，以细菌培养作为肺炎诊断金标准，最终确诊为肺炎患者53例，为研究组，其余52例为对照组。所有患者均进行彩色多普勒超声检测，并且通过酶联免疫吸附测定法（ELISA）检测患者血清TLR4、KL-6水平，对比两组超声定量参数，分析肺炎患者肺部超声参数与TLR4、KL-6水平之间的相关性以及与病情严重程度之间的相关性，分析超声参数、TLR4、KL-6水平对肺炎的诊断价值。与对照组相比，研究组上升时间（RT）、峰值强度（PI）水平升高；达峰时间（TTP）水平降低（P<0.05）。与轻、中度肺炎患者相比，重度肺炎患者RT、PI参数水平及TLR4、KL-6水平均升高，TTP参数水平均降低（P<0.05）。RT、PI与TLR4、KL-6水平呈正相关；TTP参数与TLR4、KL-6水平呈负相关（P<0.05）。与肺部超声参数、TLR4、KL-6水平相比，联合诊断对肺炎的诊断效能最高（P<0.05）。超声参数与TLR4、KL-6水平，以及肺炎严重程度之间具有相关性，上述指标的联合诊断对肺炎具有较高的诊断价值。

关键词: 超声参数, 肺炎, Toll样受体4, 涎液化糖链抗原-6

Abstract: This paper analyzed the correlation of ultrasound parameters with Toll-like receptor 4 (TLR4), Kerbs von den lungen-6 (KL-6) and their diagnostic value in pneumonia. 105 patients with suspected pneumonia were selected as the research subjects. Bacterial culture was used as the gold standard for the diagnosis of pneumonia, and 53 patients with pneumonia were finally diagnosed as the research group and the remaining 52 cases were the control group. All patients underwent color Doppler ultrasound detection, and detected the serum TLR4 and KL-6 levels by enzyme-linked immunosorbent assay (ELISA). The quantitative ultrasound parameters of the two groups were compared. The correlation between lung ultrasound parameters and TLR4, KL-6 levels and the severity of the disease in patients with pneumonia were analyzed, and the diagnostic value of ultrasound parameters, TLR4, KL-6 levels for pneumonia was analyzed. Compared with the control group, the parameter levels of rise time (RT) and peak intensity (PI) in the research group increased, and the time to peak (TTP) level decreased (P<0.05). Compared with patients with mild and moderate pneumonia, the levels of RT and PI parameters, as well as the levels of TLR4 and KL-6 in patients with severe pneumonia were increased, while the levels of TTP parameters were decreased (P<0.05). RT and PI parameters were positively correlated with TLR4 and KL-6 levels (P<0.05), and TTP parameters were negatively correlated with TLR4 and KL-6 levels (P<0.05). Compared with lung ultrasound parameters, TLR4 and KL-6 levels, combined diagnosis had the highest diagnostic performance for pneumonia (P<0.05). Ultrasound parameters were correlated with TLR4, KL-6 levels and the severity of pneumonia, and the combined diagnosis of the above indicators has high diagnostic value for pneumonia.

Key words: ultrasound parameters, pneumonia, Toll-like receptor 4, kerbs von den lungen-6

张应华, 杨玲. 超声参数与TLR4、KL-6的相关性及对肺炎诊断的意义[J]. 影像科学与光化学, 2023, 41(1): 74-78.

ZHANG Yinghua, YANG Ling. Correlation of Ultrasonic Parameters with TLR4, KL-6 and Its Significance in the Diagnosis of Pneumonia[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(1): 74-78.

参考文献

[1] Eshwara V K, Mukhopadhyay C, Rello J. Community-acquired bacterial pneumonia in adults:An update[J]. The Indian Journal of Medical Research, 2020, 151(4):287-302.
[2] le Roux D M, Zar H J. Community-acquired pneumonia in children-a changing spectrum of disease[J]. Pediatric Radiology, 2017, 47(11):1392-1398.
[3] Lanks C W, Musani A I, Hsia D W. Community-acquired Pneumonia and Hospital-acquired Pneumonia[J]. The Medical Clinics of North America, 2019, 103(3):487-501.
[4] 戴九龙, 柳建华. 彩色多普勒超声与胸部DR在肺炎诊断中的价值比较及肺炎声像特征[J]. 实用医学杂志, 2014, 30(22):3630-3632.
[5] 宋威, 万健, 白金霞, 等. HMGB1/TLR4通路在患反复支气管肺炎的老年患者治疗中的作用[J]. 临床和实验医学杂志, 2022, 21(7):712-715.
[6] 李双凤, 高延秋, 李晓燕, 等. EVLWI、sICAM-1和KL-6联合检测在重症肺炎ARDS患者预后评估中的价值[J]. 中华急诊医学杂志, 2021, 30(6):730-736.
[7] 中华医学会呼吸病学分会感染学组. 中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018年版)[J]. 中华结核和呼吸杂志, 2018, 41(4):255-280.
[8] 梁晓宁, 郭瑞君, 李硕. 超声技术在抗Jo-1抗体阳性的间质性肺炎病因诊断治疗中的价值[J]. 中国超声医学杂志, 2022, 38(6):653-656.
[9] 杨晓静. 高分辨胸部CT对肺炎型肺癌的鉴别诊断价值研究[J]. 中国CT和MRI杂志, 2022, 20(5):77-79, 91.
[10] 胡莎莎, 朱永北, 董迪, 等. 基于胸部X线卷积神经网络模型诊断儿童不同病原体社区获得性肺炎[J]. 中国医学影像技术, 2021, 37(8):1163-1167.
[11] 冯国隽, 王俊, 杨红梅, 等. 肺部彩色多普勒超声在成人社区获得性肺炎的临床应用价值[J]. 重庆医学, 2017, 46(27):3792-3794.
[12] 童燕燕, 刘巨方, 马静, 等. 肺部超声联合降钙素原检测对重症肺炎和非重症肺炎鉴别诊断的临床价值[J]. 中国医药导刊, 2022, 24(4):375-379.
[13] 罗源, 许继梅, 王继灵. 肺部超声联合CRP、PCT、sTREM-1检测及CPIS评分在呼吸机相关性肺炎早期诊断中的价值[J]. 分子诊断与治疗杂志, 2022, 14(1):58-62.
[14] 黄钰峰, 郑智慧, 杨梅林, 等. T淋巴细胞、TLR4与NF-κBp65在脑卒中相关性肺炎患者血清中的表达及意义[J]. 当代医药论丛, 2022, 20(13):66-68.
[15] 郭冬梅, 张红卫, 罗绮雯. 结缔组织病相关间质性肺炎患者血清KL-6与LDH水平变化及其临床意义[J]. 重庆医学, 2020, 49(22):3733-3738.
[16] 郑国平, 田孝瑞, 苗士领. 重症肺炎患者血清circ_0009128表达及其与TLR4、免疫功能的相关性研究[J]. 实验与检验医学, 2022, 40(1):26-29, 39.
[17] 李莲梅, 余博文, 毕建朋, 等. TLR4对肺炎链球菌诱导的A549细胞凋亡的影响[J]. 郑州大学学报(医学版), 2019, 54(1):73-77.
[18] 陈曦, 唐洁, 胡冬, 等. KL-6、TH17和糖蛋白抗原对CTD-ILD与细菌感染性肺炎的鉴别研究[J]. 西南国防医药, 2020, 30(12):1080-1083.
[19] 彭亮, 乔婕, 郑成东, 等. 小儿危重症病例评分联合血清可溶性髓样细胞触发受体1、涎液化糖链抗原-6水平对重症肺炎患儿预后的预测价值研究[J]. 实用心脑肺血管病杂志, 2019, 27(10):45-49.
[20] 魏望, 薛存, 陆丹, 等. IL-1β、TLR4、CRP与新冠肺炎危重程度(CURB-65分级)相关性及预后影响因素分析[J]. 检验医学与临床, 2021, 18(13):1862-1865.