The Diagnostic Value Of The Detection Of The Proteases And IL-8 In BALF In Patients With HAP

Objective:We used clinical diagnostic criteria and pathogenic criteria for grouping, to study the diagnostic value of HNE, MMP-8, MMP-9, IL-8 in broncho alveolar lavage fluid in hospital-acquired pneumonia, and to explore their diagnostic value in hospital-acquired pneumonia as a new infectous index.Methods:Based on the clinical diagnostic criteria and/or the pathogenic criteria, 55 patients were divided into HAP group and non-HAP group. We used the bronchoscope to collect alveolar lavage fluid from the focus of infection of lower respiratory tract, measured the concentration of HNE by ELISA method, MMP-8, MMP-9, IL-8, and collected the venous blood of patients in both groups at the same time to detect the concentrations of IL-8 in serum and BALF to explore the sensitivity and specificity of the proteases and IL-8 in BALF for the diagnosis of hospital-acquired pneumonia.Results:1. The proteases HNE, MMP-8, and MMP-9 were significantly increased in BALF from patients with HAP as compared with those without HAP, and the differences were statistically significent(P<0.05). HNE in BALF, at a cutoff of 83.2 ng/ml, identified HAP with a sensitivity of 82.4% and specificity of 95.2%.2. The level of IL-8 were also significantly increased in BALF from patients with HAP as compared with those without HAP, and the differences were statistically significent(P<0.05). For the patients with HAP, when compared with the IL-8 in serum, its increases were much more significent in BALF, and the differences were statistically significent(P<0.05).Conclusion:Proteases IINE, MMP-8, MMP-9 in bronchoscope lavage fluid have good sensitivity and specificity in the diagnoses of HAP, and the procedure is simple and quick, and is promising to become a relatively accurate diagnostic methods for hospital-acquired pneumonia. IL-8 in BALF from the patients with HAP increased more significantly, and the specimens were collected from lung parenchyma, so they have good correlationship with lung inflammations, and can be used for early diagnosis of HAP and to guide antibiotic empiric treatment.