摘要
目的探讨白细胞介素 6(IL 6)、降钙素原(PCT)在脓毒症患者中的表达水平及其临床意义。方法分析80例脓毒症患者,根据脓毒症分级标准分为普通脓毒症组(n=38)、严重脓毒症组(不伴休克)(n=22)、脓毒症休克组(n=20),并纳入40例无感染者为对照组,比较四组受试者IL 6、PCT水平,ROC分析IL 6、PCT对脓毒症的诊断效能,建立Logistic风险预测模型,分析IL 6、PCT对脓毒症预后的预测价值。结果普通脓毒症组、严重脓毒症组(不伴休克)、脓毒症休克组血清IL 6、PCT水平与对照组(无感染者)对比均明显升高(P<0.05);普通脓毒症组、严重脓毒症组(不伴休克)和脓毒症休克组组间差异显著(P<0.05),IL 6、PCT以表达水平高低排序为脓毒症休克组>严重脓毒症组(不伴休克)>普通脓毒症组;ROC分析结果示IL 6、PCT的AUC分别为0.806(95%CI:0.96~10.61,P=0.000),0.892(95%CI:1.28~9.16,P=0.000),IL 6、PCT其灵敏度、特异度分别为89.61%、86.76%;90.35%、87.26%;IL 6>56.12 pg/mL、PCT>1.10 ng/mL在脓毒症预后预测模型中OR分别为:9.35(98%CI:1.96~8.92)、12.98(95%CI:0.89~12.39),是预测脓毒症患者不良结局的独立预测因子。结论IL 6、PCT在脓毒症患者以及不同感染程度脓毒症患者中均有不同程度的表达,可用于脓毒症早期诊断,提示能预测脓毒症患者预后。
Objective To investigate the expression and clinical significance of interleukin 6(IL 6)and procalcitonin(PCT)in patients with sepsis.Methods According to the criteria of sepsis classification,80 patients with sepsis was divided into the general sepsis group,the severe sepsis group(without shock),and the septic shock group according to the sepsis grading criteria,and 40 patients with no infection were included as controls group.The levels of IL 6 and PCT in the four groups were compared.ROC was used to analyze the diagnostic efficacy of IL 6 and PCT for sepsis.A Logistic risk prediction model was established to analyze the predictive value of IL 6 and PCT for the prognosis of sepsis.Results Serum IL 6 and PCT levels in the general sepsis group,severe sepsis group(without shock),and septic shock group were significantly higher than control group(P<0.05).There were significant differences between the general sepsis group,the severe sepsis group(without shock),and the septic shock group(P<0.05).IL 6 and PCT were ranked as sepsis in the three groups.Shock group>severe sepsis group(without shock)>general sepsis group.ROC analysis showed that the AUC of IL 6 and PCT were 0.806(95%CI:0.96~10.61,P=0.000),0.892(95%CI:1.28~9.16,P=0.000).The sensitivity and specificity of IL 6 and PCT were 89.61%and 86.76%;90.35%and 87.26%.IL 6>56.12 pg/mL,PCT>1.10 ng/mL in the prognosis prediction model of sepsis were:9.35(98%CI:1.96~8.92),12.98(95%CI:0.89~12.39),with independent predictor of adverse outcomes in patients with sepsis.Conclusion The expression of IL 6 and PCT in sepsis patients and sepsis patients with different degrees of infection can be used for early diagnosis of sepsis,suggesting that they can predict the prognosis of sepsis patients.
作者
刘蕾蕾
华玮
居培红
张雯艳
黄侃
李铮
LIU Leilei;HUA Wei;JU Peihong;ZHANG Wenyan;HUANG Kan;LI Zheng(Department of emergency Yangpu Hospital Affiliated to Tongji University,Shanghai,China,200093)
出处
《分子诊断与治疗杂志》
2019年第6期527-530,共4页
Journal of Molecular Diagnostics and Therapy
基金
上海市杨浦中心医院2017年立项(Se1201710)
