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新冠肺炎?感染?肿瘤?白介素6帮你来解析!

2020-06-16 检验医学网 检验医学网

2019年末2020年初,新型冠状病毒肺炎引起全球的关注。重症新型冠状肺炎患者由于“细胞因子风暴”,而引起急性呼吸窘迫综合征和多器官衰竭,危及生命。

2019年末2020年初,新型冠状病毒肺炎引起全球的关注。重症新型冠状肺炎患者由于“细胞因子风暴”,而引起急性呼吸窘迫综合征和多器官衰竭,危及生命。

而细胞因子风暴的诊断主要依赖检测外周血中的炎性因子有无升高,白介素6在初级和二级风暴中均发挥重要作用,其在外周血中含量进行性升高。而且由于白介素6在实验室检测中具有方便快捷,准确性高的优点,因此其在诊断“细胞因子风暴”中发挥重要的作用。

并有临床试验(ChiCTR2000029765)证明应用白介素6受体阻断剂托珠单抗对新冠肺炎治疗的有效性和安全性。此外,高浓度的白介素6可以诱导血栓形成、血管渗漏和心肌功能障碍等相关机能损伤,导致组织缺氧、低血压、多器官功能障碍。因此,早期的阻断治疗尤为重要。

白介素6作为新型的感染相关标志物,在临床诊断感染性疾病同样发挥着重要作用:

①当感染和炎症发生后,白介素6率先生成,并在产生后诱导降钙素原(PCT)和C反应蛋白(CRP)升高;研究显示,细菌感染后白介素6迅速升高,PCT在2h后升高,而CRP在6h后才升高。

②白介素6升高与疾病的严重程度呈正相关,增高幅度反映病情的严重程度。特别是全身性感染时升高更为明显,它的水平升高提示患者有发生脓毒症的高风险。

③PCT、白介素6、CRP相比,白介素6的敏感性优于PCT和CRP,但它的特异性不如PCT,联合检测可以优势互补。

④白介素6可用来评价感染严重程度和评估预后,当白介素6过高时预警重症感染患者预后不良。

近年来,白介素6与肿瘤的预后关系也备受学者的关注,研究发现其与多种肿瘤的预后相关,如鼻咽癌、食管癌、结肠癌等,常规肿瘤标志物与白介素6联合检测在肿瘤预后评价中具有重要的作用。

可见,白介素6在新型冠状病毒肺炎、感染、肿瘤预后评估中不容忽视。

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    2020-10-10 hongbochen
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    2020-06-17 公卫新人

    新冠肺炎,疫情何时才能消失

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