摘要
目的分析血清降钙素原(PCT)、高敏C反应蛋白(hs-CRP)和白介素-6(IL-6)表达水平与脓毒症的关系,并探讨其预测脓毒症预后的价值。方法选取中南大学湘雅医学院附属海口医院重症医学科2014年2月至2017年1月收治的脓毒症患者58例为研究对象,根据患者4周内是否死亡分为死亡组(n=22)和生存组(n=36)。采用双抗体免疫夹心法检测患者入院当天血清PCT水平,免疫比浊法检测血清hs-CRP水平,酶联免疫吸附法检测血清IL-6水平。比较两组患者上述指标有无差异,并计算上述指标预测患者死亡的敏感性、特异性和ROC曲线下面积。结果死亡组患者入院当天血清PCT、hs-CRP及IL-16水平分别为(9.31±3.90)μg/L、(68.65±19.128)mg/L和(31.09±10.29)ng/L,明显高于生存组的(2.84±1.781)μg/L、(54.54±15.50)mg/L和(21.70±5.99)ng/L,且差异均有统计学意义(P<0.05);血清PCT、CRP及IL-6预测脓毒症患者4周死亡的敏感性分别为90.23%、80.62%和77.32%,特异性分别为61.36%、67.23%和63.24,ROC曲线下面积分别为0.93、0.71和0.75。Pearson相关性检验显示,死亡组患者的hs-CRP与PCT(r=0.63,P<0.05)、IL-6与PCT(r=0.60,P<0.05)及IL-6与hs-CRP(r=0.34,P<0.05)均呈正相关。结论 4周内死亡患者血清PCT、hs-CRP和IL-6水平显著增高,可作为预测死亡风险的血清学标志物。
Objective To analyze the association between serum level of procalcitonin（PCT）, C-reactive protein（hs-CRP）, interleukin-6（IL-6） and septicemia, and to assess their significance in evaluating the prognosis of patients with sepsis. Methods From Feb. 2014 to Jan. 2017, 58 patients of sepsis were recruited from ICU, Haikou Hospital Affiliated to Xiangya School Of Medicine, Central South University. The patients were divided into dead group（n=22） and survival group（n=36） according to weather the patients died in 4 weeks. The serum levels of PCT, hs-CRP and IL-6 were tested at hospitalization and compared between the two groups. The diagnostic sensitivity and specificity, and area under the ROC curve（AUC） of the indexes were calculated. Results The serum levels of PCT, hs-CRP and IL-6 were（9.31±3.90） μg/L,（68.65±19.128） mg/L and（31.09±10.29） ng/L in death group versus（2.84±1.781） μg/L,（54.54±15.50） mg/L,（21.70±5.99） ng/L in survival group（P0.05）. The predictive sensitivity of serum PCT, hs-CRP and IL-6 for death in 4 weeks were 90.23%, 80.62% and 77.32%, and the specificity were 61.36%, 67.23% and 63.24, respectively, with AUC of 0.93, 0.71 and 0.75, respectively. Pearson correlation analysis showed significant positive correlations between serum hs-CRP and PCT（r=0.63, P0.05）, IL-6 and PCT（r=0.60, P0.05）, IL-6 and hs-CRP（r=0.34, P0.05）in sepsis patients died within 4 weeks. Conclusion The serum PCT, hs-CRP and IL-6 were significant elevated in sepsis patients died within 4 weeks, which could serve as potential biomarkers for prognosis of septic disease.
出处
《海南医学》
CAS
2018年第2期212-214,共3页
Hainan Medical Journal
