摘要
目的 :确定全身性感染患者的传统炎症指标〔体温、白细胞计数、中性粒细胞比例、中性粒细胞计数、C反应蛋白 (CRP)〕及降钙素原 (PCT)与白介素 6 (IL 6 )水平间的相关关系。方法 :共有 5 1例患者入选。临床发生全身性感染或全身性炎症反应综合征 (SIRS)后 2 4小时内测定血清 PCT、IL 6和 CRP,同时记录白细胞计数、中性粒细胞比例、中性粒细胞计数和最高体温。结果 :PCT与血清 IL 6水平密切相关。比较受试者工作特征曲线下面积 (AU C) ,PCT对 IL 6水平 (以 5 0 0 ng/ L 和 10 0 0 ng/ L 作为临界值 )的预测能力最强 (分别为 0 .6 85和 0 .85 8) ,体温 (分别为 0 .6 6 2和 0 .792 )和 CRP(分别为 0 .6 2 5和 0 .72 7)的预测能力中等 ,而白细胞计数、中性粒细胞比例和中性粒细胞计数的预测能力最差。 PCT的敏感性、特异性、阳性预期值和阴性预期值也最高。结论 :与传统的炎症指标相比 。
Objective:To determine the correlations and predictive capability of conventional inflammatory markers 〔body temperature,white blood cell (WBC) count,percentage of neutrophils,absolute neutrophil count (ANC),Creactive protein (CRP)〕 and procalcitonin (PCT) with elevated levels of interleukin6( IL6 ) in septic patients.Methods:Fiftyone patients were enrolled in the study.Serum concentrations of PCT,IL6 and CRP were determined within 24 hours after clinical onset of sepsis or systemic inflammatory response syndrome.WBC count,percentage of neutrophils,and ANC,as well as maximal body temperature were also recorded.Results:PCT was significantly correlated with serum IL6 levels.Based on area under curve of the receiver operating characteristics curves,the predictive capability was highest for PCT (0 685,for IL6,500 ng/L;and 0 858,for IL6,1 000 ng/L),moderate for body temperature (0 662 and 0 792, respectively) and CRP (0 625 and 0 727,respectively),and lowest for WBC count,percentage of neutrophils and ANC.Sensitivity,specificity,positive and negative predictive values all followed the same pattern of being highest for PCT.Conclusions:Compared with conventional inflammatory markers,PCT may reflect more reliably the elevated levels of proinflammatory cytokines.
出处
《中国危重病急救医学》
CAS
CSCD
2002年第8期474-477,共4页
Chinese Critical Care Medicine
