分析支气管扩张患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、中性粒细胞百分比(NEU%)变化与疾病严重程度的关系。

选取2019年1月至2021年5月我院收治的102例支气管扩张急性加重期患者为对象，按疾病严重程度分为轻度组21例、中度组42例与重度组39例，记录3组入院时及出院时血清TNF-α、IL-6及NEU%变化情况，评估入院时支气管扩张严重程度指数(BSI)与TNF-α、IL-6、NEU%的相关性；记录急性复发再入院情况，比较复发者与未复发者TNF-α、IL-6、NEU%变化情况。

3组住院期间未出现死亡病例，入院时重度组TNF-α(59.32±6.99)pg/ml、IL-6(63.44±8.21)pg/ml及NEU%(81.35±4.05)%高于中度组TNF-α(44.28±6.27)pg/ml、IL-6(50.09±6.27)pg/ml及NEU%(72.19±5.17)%及轻度组TNF-α(35.07±4.96)pg/ml、IL-6(39.45±7.51)pg/ml及NEU%(66.27±3.95)%(P<0.05)；出院时3组TNF-α[(29.07±5.48)vs. (27.69±5.73)vs.( 26.32±5.82)]pg/ml、IL-6[(34.08±7.30)vs. (32.69±5.94)vs. (30.85±6.12)]pg/ml及NEU%[(57.24±3.91)vs. (56.55±3.96)vs. (54.93±4.91)]%较入院时降低(P<0.05)，组间比较差异无统计学意义(P>0.05)。Pearson相关性分析显示，患者入院时BSI指数与TNF-α、IL-6、NEU%正相关(r＝0.612、0.571、0.734，P<0.05)。出院后随访1年，14例失访(13.73%)，复发45例(51.14%)，21例复发2~3次，复发者出院时TNF-α、IL-6及NEU%高于未复发者(P<0.05)，复发者再入院时上述指标高于出院时(P<0.05)。

TNF-α、IL-6及NEU%参与支气管扩张急性加重的发生、发展，可评估预后复发情况。

To analyze the changes in serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and neutrophil percentage (NEU%) in patients with bronchiectasis and their relationship with disease severity.

All of 102 patients with acute exacerbation of bronchiectasis in the hospital from January 2019 to May 2021 were selected as the research subjects. The disease severity was assessed by Bronchiectasis Severity Index (BSI) at admission, thus the patients were divided into mild, moderate and severe groups. The changes in serum TNF-α, IL-6 and NEU% levels at admission and at discharge were recorded in the three groups, and the correlation between BSI index and serum TNF-α, IL-6 and NEU% levels at admission was evaluated. At 1 year of follow-up after discharge, the readmission status of patients with acute recurrence was recorded, and the changes in serum TNF-α, IL-6, and NEU% were compared between patients with recurrence and patients without recurrence.

There were no deaths during hospitalization in the three groups. At admission, the levels of serum TNF-α(59.32±6.99)pg/ml, IL-6(63.44±8.21)pg/ml and NEU%(81.35±4.05)% were higher in severe group than those in moderate TNF-α(44.28±6.27)pg/ml, IL-6(50.09±6.27)pg/ml and NEU%(72.19±5.17)% and mild groups TNF-α(35.07±4.96)pg/ml, IL-6(39.45±7.51)pg/ml and NEU%(66.27±3.95)% (P<0.05). The levels of serum TNF-α[(29.07±5.48)vs. (27.69±5.73)vs.( 26.32±5.82)] pg/ml, IL-6[(34.08±7.30)vs. (32.69±5.94)vs. (30.85±6.12)]pg/ml and NEU%[(57.24±3.91)vs. (56.55±3.96)vs. (54.93±4.91)]% in the three groups at discharge were reduced compared with those at admission (P<0.05), but there were no statistical differences among the three groups at discharge (P>0.05). Pearson correlation analysis showed that BSI index at admission was significantly positively correlated with serum TNF-α, IL-6 and NEU% levels in patients with acute exacerbation of bronchiectasis (r=0.612, 0.571, 0.734, P<0.05). During 1-year follow-up after discharge, 14 patients were lost to follow-up, with a loss-to-follow-up rate of 13.73%. Among the 88 patients, there were 45 cases (51.14%) of recurrence, including 21 cases with 2 to 3 recurrences during 1 year. Serum levels of TNF-α, IL-6 and NEU% in recurrent patients at discharge were higher than those in non-recurrent patients (P<0.05), and the above indicators in recurrent patients were significantly higher at readmission than at discharge (P<0.05).

TNF-α, IL-6 and NEU% are involved in the occurrence and development of acute exacerbation of bronchiectasis, and are beneficial for evaluating the prognosis and recurrence of patients.