| 马玉仓,方长太,黄利娟,等.白细胞介素-35在脓毒症中的变化及其与病情严重程度的相关性[J].安徽医药,2018,22(10):1905-1908. |
| 白细胞介素-35在脓毒症中的变化及其与病情严重程度的相关性 |
| Changes of plasma interleukin-35 in patients with sepsis and its correlation with severity of disease |
| 投稿时间：2017-11-20 |
| DOI： |
| 中文关键词: 脓毒症 白细胞介素-35 降钙素原 |
| 英文关键词: Sepsis Interleukin-35 Procalcitonin |
| 基金项目:安徽省公益性技术应用研究联动项目(1704f0804036) |
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| 中文摘要: |
| 目的 观察脓毒症患者血清白细胞介素-35(IL-35)的变化规律,探讨其与脓毒症病情严重程度的关系及对疾病预后的预测价值。 方法 采用前瞻性单中心单盲临床研究方法,选择在安徽医科大学附属安庆医院重症医学科 2016 年 10月至 2017年 10 月间住院的脓毒症患者中筛选出符合研究要求的病例74 例,并根据全身感染严重程度及有无器官功能不全,将脓毒症患者分为一般脓毒症组和脓毒症性休克组。同期选择 60 例健康志愿者作为健康对照组。患者入院6 h、 48 h、d5取血,采用酶联免疫吸附试验(ELISA)检测降钙素原(PCT)、 IL-35,计算序贯器官衰竭(SOFA)评分；同时记录患者转归。 分析脓毒症患者IL-35 与上述指标的相关性；绘制受试者工作特征曲线(ROC)获得 IL-35 诊断感染的价值。 结果 血清IL-35中位值比较,一般脓毒症组45.56 ng·L-1和脓毒症性休克组47.77 ng·L-1较健康对照组0.34 ng·L-1明显升高(Z＝1.314,P＜0.01),随病情严重程度增加,脓毒症患者PCT中位值明显上升[一般脓毒症组35.00 μg·L-1,毒症性休克组1.15 μg·L-1,(Z＝-6.253,P＜0.001)]。 一般脓毒症组患者随病情好转,SOFA评分、PCT、 IL-35逐渐下降；脓毒症休克组患者随病情加重,SOFA评分、PCT、 IL-35逐渐升高。IL-35与 SOFA 评分随入院时间的增长呈显著正相关。 ROC 曲线分析显示 IL-35、PCT 诊断感染的 ROC 曲线下面积(AUC)分别为 0.76、0.94。 当 IL-35截断值为 41.97 ng·L-1 时的敏感度为 94.00%,特异度为60.00% ；当 PCT截断值为 3.65 μg·L-1时敏感度为88.00%,特异度为80.00%。 结论 脓毒症患者入院时血清IL-35即明显上升,与 PCT水平呈正相关,对脓毒症的病情变化有诊断意义；血浆 IL-35 与脓毒症严重程度有关,其变化趋势对脓毒症患者的预后有提示意义。 |
| 英文摘要: |
| Objective To observe the changes of plasma interleukin-35 (IL-35) in patients with sepsis,and to explore its relationship with the severity of sepsis and its predictive value for disease prognosis. Methods A prospective single center single blind clinical research methods was used to select 74 cases of sepsis patients hospitalized from October 2016 to October 2017 in Department of Severe Medicine,Anqing Hospital Affiliated to Medical University Of Anhui.According to the severity of systemic infection and without organ dysfunction,patients with sepsis were assigned into general sepsis group and septic shock group.At the same time,60 healthy volunteers were selected as healthy control group.Patients were hospitalized with 6 h,48 h and d5,enzyme-linked immunosorbent assay (ELISA) was used to detect procalcitonin (PCT) and IL-35 in blood,sequential organ failure (SOFA) scores were calculated,and patients ' prognosis was recorded.The correlation between IL-35 and the above indexes in patients with sepsis was analyzed,and the working characteristic curve (ROC) was drawn to obtain the value of IL-35 in diagnosis of infection. Results Serum IL-35 in general sepsis group(45.56 ng· L-1) and septic shock group(47.77 ng·L-1) was increased significantly than that in healthy control group(0.34 ng· L-1)(Z＝1.314,P< 0.01),PCT increased significantly in sepsis with the severity of the disease increased (Z=-6.253,P<0.001),PCT in general sepsis group was 35.00 μg·L-1,PCT in septic shock group was 1.15 μg·L-1.In general sepsis group,the SOFA score,PCT and IL-35 decreased gradually with the improvement of the disease;the SOFA score,PCT and IL-35 gradually increased with the aggravation of the disease in the septic shock group.IL-35 and SOFA score were positively correlated with the increase of admission time.ROC curve analysis showed that the area under the ROC curve (AUC) of IL-35 and PCT for diagnosis of infection was 0.76 and 0.94.When the cutoff value of IL-35 was 41.97 ng·L-1,the sensitivity was 94%,the specificity was 60%;the sensitivity was 88% and the specificity was 80% when the cut-off value of PCT was 3.65 μg·L-1. Conclusions Serum IL-35 in patients with sepsis is increased significantly at admission,which is positively correlated with the level of PCT,and has a diagnostic significance for the change of sepsis,and the change trend of plasma IL-35 is related to the severity of sepsis,its tendency is helpful to the prognosis of patients with sepsis. |
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