To Investigate The Value Of Plasma IL-6,IL-10,IL-6/IL-10 Ratio,TNF-α And IFN-γ In The Diagnosis And Management Of Infectious Pneumonia

Objective: In this study,the levels of plasma interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),and interferon-γ(IFN-γ)were measured in patients with bacterial pneumonia,non-bacterial pneumonia and healthy controls,and the analysis was performed to compare the blood levels of IL-6,IL-10,IL-6/IL-10 ratio,TNF-α,IFN-γ and C-reactive protein(CRP),and white blood cell(WBC)counts in patients with different types of infectious pneumonia and patients with bacterial pneumonia at different degrees of infection.The diagnostic efficacy of each index for infectious pneumonia and differential bacterial pneumonia was analyzed using the receive operating characteristic curve(ROC)to investigate the value of plasma IL-6,IL-10,IL-6/IL-10 ratio,TNF-α and IFN-γ levels in the diagnosis and management of infectious pneumoniaMethod: A total of 108 patients with infectious pneumonia(including 74 patients with bacterial pneumonia,34 patients with non-bacterial pneumonia)and 42 healthy people as the control group in the x from November 2020 to September 2021 were enrolled as the subject in this research.The bacterial pneumonia group was further divided into severe bacterial pneumonia group(49 cases)and mild bacterial pneumonia group(25 cases)according to CPIS score.The levels of IL-6,IL-10,TNF-α and IFN-γ were tested with Flow cytometry,the IL-6/IL-10 ratio were calculated in the bacterial pneumonia group.The levels of CRP were measured by scattering turbidimetry.The WBC counts were detected by flow cytometry with a semiconductor laser.The differences in blood levels of IL-6,IL-10,TNF-α,IFN-γ,CRP and WBC between the groups were statistically analyzed,as well as the differences in all testing indicators in patients with different degrees of infection.The Mann-Whitney U test was used to compare the group differences of each indicator,Graph Pad prims 8.0 was used to plot the scatter plots of the concentration distribution of each indicator,Spearman correlation coefficient was used to analyze the correlation between all the indicators and CPIS score in patients with bacterial pneumonia,and ROC curve was used to evaluate the diagnostic ability of each index for infectious pneumonia and identify bacterial pneumonia.Results: The levels of IL-6,IL-10,TNF-α,IFN-γ,CRP and WBC in the bacterial pneumonia group and the non-bacterial pneumonia group were higher than in the control group(Z=-8.657,-7.463,-4.353,-4.614,-7.969,-6.020,P<0.001.Z=-5.496,-3.642,-2.514,-3.800,-3.693,-2.549,P<0.05).The levels of IL-6,IL-10,CRP and WBC in bacterial pneumonia group were significantly higher than non-bacterial pneumonia group(Z=-6.579,-4.710,-4.323,-2.909,P<0.01),while the differences in TNF-α and IFN-γ were not statistically significant(Z=-1.684,-1.016,P>0.05).Among them,IL-6,IL-10,CRP and WBC levels were higher in the severe bacterial pneumonia group than in the non-bacterial pneumonia group(Z=-7.404,-4.909,-5.035,-3.134,P<0.01).The levels of IL-6 and IL-10 in the mild bacterial pneumonia group were significantly higher than in the nonbacterial pneumonia group(Z=-2.991,-2.792,P<0.01),while the differences in CRP and WBC were not statistically significant(Z=-1.018,-1.228,P>0.05).The levels of IL-6,IL-10,IL-6/IL-10 ratio and CRP were significantly higher in the severe bacterial pneumonia group than in the mild bacterial pneumonia group(Z=-5.446,-2.063,-5.263,-7.127,-3.316,P<0.05),while the differences in TNF-α,IFN-γ and WBC were not statistically significant(Z=-0.524,-0.556,-1.678,P>0.05).Spearman correlation analysis showed that IL-6 and IL-6/IL-10 ratio were significantly positively correlated with CPIS score in patients with bacterial pneumonia(r=0.718,0.683,P<0.001).ROC curve analysis showed that the area under the ROC curve for the diagnosis of infectious pneumonia by IL-6,IL-10,TNF-α,IFN-γ,CRP and WBC was 0.945,0.859,0.719,0.743,0.897 and 0.789,respectively.Combined detection of IL-6,IL-10 and CRP in the diagnosis of infectious pneumonia AUC is 0.950.The AUCs of IL-6,IL-10,CRP,and WBC for the differential diagnosis of bacterial and non-bacterial pneumonia were 0.924,0.811,0.792,and 0.697,respectively.Conclusion: 1.The levels of IL-6,IL-10,TNF-α and IFN-γ could be used for the differential diagnosis of infectious pneumonia.The combined detection of IL-6,IL-10 and CRP could improve the sensitivity and specificity for diagnosis of infectious pneumonia.2.The differential diagnosis value of IL-6 for the bacterial pneumonia is superior to IL-10,CRP and WBC,and is useful in guiding clinicians in the application of antibacterial drugs.3.IL-6 and IL-6/IL-10 ratios can assess the severity of infection in patients with pneumonia,the higher the concentration and the greater the ratio,the more severe the infection is likely to be in patients with pneumonia.