ARDS血清细胞因子与病情严重程度及炎性衰老的相关性研究

Study on the Correlation between Serum Cytokines in ARDS and Disease Severity as Well as Inflammaging

摘要: 目的：探讨急性呼吸窘迫综合征(ARDS)老年患者血清细胞因子表达水平与ARDS病情严重程度及炎性衰老标志物C反应蛋白(CRP)的相关性分析。方法：回顾性选取2023年8月至2025年3月在绍兴市人民医院重症监护室收住的152例ARDS老年患者为研究对象，比较不同病情严重程度下白介素-6 (IL-6)、白介素-10 (IL-10)、血清肿瘤坏死因子-α (TNF-α)、干扰素-γ (IFN-γ)表达水平，另收集入组的ARDS老年患者出院后在我院随访的炎性衰老标志物CRP值和同期于我院健康体检的160例非ARDS的健康老年人CRP值，应用倾向性评分匹配法对组间混杂因素进行校正，比较两组血清CRP水平差异。并进一步分析细胞因子表达水平与炎性衰老标志物CRP的相关性。结果：病情严重程度越高的ARDS老年患者IL-6、TNF-α、干扰素γ均值越高，而IL-10表达水平随病情严重程度加重而降低。ARDS老年幸存者CRP水平较非ARDS的健康老年人显著升高，差异有统计学意义(P < 0.05)。Spearman相关分析发现，炎性衰老标志物CRP表达水平与IL-6、TNF-α、干扰素γ均呈正相关(r = 0.4896, 0.6307, 0.5352, P < 0.001)，与IL-10未见显著相关性(r = 0.1904, P = 0.2391)。结论：急性呼吸窘迫综合征老年患者的IL-6、TNF-α、干扰素γ的过度表达与病情严重程度、炎性衰老标志物CRP水平均呈正相关。ARDS可能通过细胞因子过度表达导致炎性衰老，可能是ARDS患者病情加重及不良预后的重要机制，密切监测指标变化，可为病情严重程度及预后评估提供一定依据。

Abstract: Objective: To investigate the correlation between serum cytokine levels and disease severity as well as the inflammaging biomarker C-reactive protein (CRP) in elderly patients with Acute Respiratory Distress Syndrome (ARDS). Methods: A retrospective study was conducted on 152 elderly ARDS patients admitted to the ICU of Shaoxing People’s Hospital between August 2023 and March 2025. The expression levels of interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) were compared across different levels of disease severity. Additionally, follow-up CRP values (the inflammaging biomarker) from the enrolled elderly ARDS patients after discharge were collected, along with CRP values from 160 non-ARDS healthy elderly individuals who underwent health checkups at our hospital during the same period. Propensity score matching was applied to adjust for confounding factors between the groups, and serum CRP levels were compared. Furthermore, the correlation between cytokine expression levels and the inflammaging biomarker CRP was analyzed. Results: Elderly ARDS patients with higher disease severity exhibited higher mean levels of IL-6, TNF-α, and IFN-γ, while IL-10 expression decreased with increasing severity. CRP levels were significantly elevated in elderly ARDS survivors compared to the non-ARDS healthy elderly controls, and the difference was statistically significant (P < 0.05). Spearman correlation analysis revealed that CRP levels were positively correlated with IL-6 (r = 0.4896), TNF-α (r = 0.6307), and IFN-γ (r = 0.5352) (all P < 0.001), but no significant correlation was found with IL-10 (r = 0.1904, P = 0.2391). Conclusions: In elderly patients with ARDS, the overexpression of IL-6, TNF-α, and IFN-γ is positively correlated with both disease severity and the level of the inflammaging biomarker CRP. ARDS may contribute to inflammaging through cytokine overexpression, which could be a significant mechanism underlying disease progression and poor prognosis. Close monitoring of these indicators may provide a basis for assessing disease severity and prognosis.