摘要
目的:探讨降钙素原(PCT)联合白细胞介素-6(IL-6)在全身性炎症反应综合征(SIRS)病因及病情诊断中的临床意义。方法:115例SIRS患者分为脓毒症组(n=46)和非感染SIRS组(n=69)。测定两组入院24h内PCT、IL-6血清水平。同时记录白细胞计数(WBC)、中性粒细胞计数(N)、中性粒细胞百分比(N%)、C-反应蛋白(CRP)及急性生理和慢性健康评分(APACHEⅡ评分)、序贯器官衰竭评分(SOFA评分)。结果:脓毒症组与非感染SIRS组在APACHEⅡ评分、SOFA评分、院内病死率方面有统计学差异(P<0.05)。脓毒症组CRP、PCT、IL-6血清水平及N%较非感染SIRS组显著升高(P<0.05)。PCT和IL-6与APACHEⅡ评分呈正相关(r=0.580,0.463),N、N%、PCT、IL-6与SOFA评分呈正相关(r=0.371,0.393,0.426,0.371),PCT与院内病死率呈正相关(r=0.349)。ROC曲线分析显示,与CRP、N、N%等炎症指标比较,PCT、IL-6、感染评分的AUC较大,诊断感染的价值较高。结论:PCT与IL-6联合应用较单一标记物检测可更有效地提高对脓毒症的鉴别能力。
Objective： To investigate the clinical application of procalcitonin （PCT） combined with interleukin-6 （IL-6） in the diagnosis of systemic inflammatory response syndrome （SIRS）. Methods： A total of 115 cases of SIRS were divided into sepsis group （ n =46） and noninfectious SIRS group （ n =69）. The serum levels of PCT and IL-6 were detected within 24 hours of admission in two groups. White blood cell count, neutrophil counts （N）, neutrophil percentage （N%）, C-reactive protein （CRP） and Acute Physiology and Chronic Health Evaluation （APACHE） Ⅱ score, Sequential Organ Failure Assessment （SOFA） Score were recorded. Results： There were significant differences in APACHE Ⅱ score, SOFA score, hospital mortality between sepsis group and noninfectious SIRS group （ P 〈0.05）. The serum levels of CRP, PCT, IL-6 and N% in sepsis group were significantly higher than those in noninfectious SIRS group （ P 〈0.05）. PCT and IL-6 were positively correlated with APACHE Ⅱ scores （ r =0.580, 0.463）, N, N%, PCT, IL-6 were positively correlated with SOFA scores （ r =0.371, 0.393, 0.371, 0.393）, and PCT was positively correlated with hospital mortality （ r =0.349）. ROC curve analysis showed that compared with CRP, N, N% and other inflammatory markers, the AUC of PCT, IL-6 and infection score was larger, and these three indicators were more valuable for clinical diagnosis. Conclusions： The combined detection of PCT and IL-6 is more effective than single detection in prognosis of sepsis.
作者
翟颖
马利
修欣欣
崔新焕
赵建祎
ZHAI Ying;MA Li;XIU Xin-xin;CUI Xin-huan;ZHAO Jian-yi(Clinical Laboratory,the Second Hospital of Bazhou City,Bazhou 065700,China;Pediatric Department,the Second Hospital of Bazhou City,Bazhou 065700,China)
出处
《海南医学院学报》
CAS
2018年第20期1803-1805,1809,共4页
Journal of Hainan Medical University
基金
廊坊市科学技术研究与发展计划(2018013039)~~
