The impact of changes in serum IL-17A and IL-10 levels on the prognosis of emergency severe pneumonia patients

Guo Rui; Wang Wu; Liu Huifeng

doi:10.3969/j.issn.1002-1949.2024.12.010

Abstract：Objective To analyze the impact of changes in serum interleukin(IL)-17A and IL-10 levels on the prognosis of emergency severe pneumonia patients.Methods A retrospective analysis was conducted on the clinical data of 246 emergency severe pneumonia patients admitted to the intensive care unit (ICU ) of Yuncheng Central Hospital Affiliated to Shanxi Medical University from April 2020 to April 2024.Patients were divided into a poor prognosis group (n=41 ) and a good prognosis group (n=205) based on their survival status within 28 d after onset.The changes of serum IL-17 A and IL-10 levels were compared between the two groups,and the effect of the two indexes on the prognosis of patients with emergency severe pneumonia was analyzed.Results The improved pneumonia score (CURB-65),acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score,the proportion of invasive mechanical ventilation,white blood cell count,D-dimer,C-reactive protein,and serum IL-17A and IL-10 levels at admission in the poor prognosis group were all higher than those in the good prognosis group (P<0.05).Cox regression analysis showed that CURB-65 score,APACHEⅡ score,white blood cell count,C-reactive protein,IL-17A and IL-10 were all influencing factors for poor prognosis in emergency severe pneumonia patients (all P<0.05).The serum IL-17A and IL-10 levels in the poor prognosis group were higher than those in the good prognosis group at admission,ICU stay for 24 h and 48 h (P<0.05).The results of the restricted cubic spline analysis showed that when IL-17A>12.04 pg/mL and IL-10>7.91 pg/mL,the risk of poor prognosis for emergency severe pneumonia patients significantly increased.The decision curve showed that when the threshold was between 0.187 and 0.437,the net return rate of the combined prediction of IL-17A and IL-10 for predicting poor prognosis was higher than that of the individual indicators(IL-17A or IL-10).When the threshold was between 0 and 1.0,the net return rate of prediction model for predicting poor prognosis based on Cox regression analysis was higher than that of IL-17A,IL-10 alone and in combination.Serum IL-17A and IL-10 had a positive interaction with the risk of poor prognosis in emergency severe pneumonia patients.Conclusions The abnormal elevation of serum IL-17A and IL-10 levels is associated with poor prognosis in the patients with severe pneumonia.Their dynamic changes indicate an imbalance between immune function and inflammatory function in the patients with severe pneumonia,and there is a positive interaction between the two indicators and the risk of poor prognosis in the patients with severe pneumonia.