IL-27联合PCT对成人脓毒症诊断、预测预后的价值
发布时间：2019-08-08 07:55
【摘要】：目的:探讨白介素-27(IL-27)在脓毒症的早期诊断、判断严重程度及预测预后上的价值。方法:纳入2014年7月—2015年7月入住江苏大学附属宜兴市人民医院重症监护室(ICU)的全身炎症反应综合征(SRIS)患者,经感染筛查(血、痰、尿液培养和X胸片),参照2012年国际脓毒症定义指南标准诊断为脓毒症并归为脓毒症组,其余归为SIRS组。根据诊断标准,再将脓毒症患者分为脓毒症、严重脓毒症和脓毒性休克。在第1、3、7天采集血液样本测定其中IL-27和降钙素原(PCT)水平,分析两组间的IL-27和PCT差别,绘制ROC曲线并计算曲线下面积(AUC)来判断其诊断价值。采用Pearson相关系数计算两指标与APACHEⅡ的相关性来评估其对判断患者病情严重程度的价值。脓毒症组随访28 d调查预后。结果:共有118例,其中脓毒症组75例,SRIS组43例。脓毒症组中包含脓毒症53例、严重脓毒症14例,脓毒性休克8例。脓毒症组第1、3、7天IL-27和PCT水平均明显高于SIRS组(P0.05),其中第1天升高最明显。IL-27的AUC为0.745,敏感性和特异性分别为66%和72%,PCT的AUC为0.836,敏感性和特异性分别为78%和75%。IL-27联合PCT检测的AUC为0.884,敏感性、特异性分别为83%,88%。IL-27和PCT水平在脓毒性休克组明显高于脓毒症组和严重脓毒症组(P0.05),并与APACHEⅡ有着较高的相关性,R2分别为0.659和0.827。28 d随访存活45例,死亡30例,死亡组IL-27和PCT水平明显高于存活组(P0.05),两者均为影响脓毒症患者预后的独立危险因素(P0.01)。结论:IL-27对脓毒症的早期诊断,严重程度的判断和预测预后均有一定帮助,但与PCT相比存在差距,联合检测IL-27和PCT对早期诊断脓毒症可以取得更好的效果。
[Abstract]:Objective: to investigate the value of IL-27 (IL-27) in the early diagnosis, severity and prognosis of sepsis. Methods: the patients with systemic inflammatory response syndrome (SRIS) admitted to the intensive care unit of Yixing people's Hospital affiliated to Jiangsu University from July 2014 to July 2015 were screened for infection (blood, sputum, urine culture and X-ray chest radiography). According to the 2012 international definition guidelines of sepsis, they were diagnosed as sepsis group and classified as sepsis group, and the rest were classified as SIRS group. According to the diagnostic criteria, sepsis patients were divided into sepsis, severe sepsis and septic shock. On the 1st and 7th day, the levels of IL-27 and procalcitonin (PCT) were measured. The differences of IL-27 and PCT between the two groups were analyzed. The ROC curve was drawn and the area (AUC) under the curve was calculated to judge its diagnostic value. The correlation between the two indexes and Apache II was calculated by Pearson correlation coefficient to evaluate its value in judging the severity of the patient's condition. The prognosis of sepsis group was investigated after 28 days follow-up. Results: there were 118 cases, including 75 cases in sepsis group and 43 cases in SRIS group. There were 53 cases of sepsis, 14 cases of severe sepsis and 8 cases of septic shock in sepsis group. The levels of IL-27 and PCT in sepsis group were significantly higher than those in SIRS group on the 1st and 7th day (P 0.05). The AUC of IL-27 was 0.745, the sensitivity and specificity were 66% and 72%, the AUC of PCT was 0.836, the sensitivity and specificity were 78%, and the sensitivity and specificity of 75%.IL-27 combined with PCT were 0.884%, 83%, respectively. The levels of 88%.IL-27 and PCT in septic shock group were significantly higher than those in sepsis group and severe sepsis group (P 0.05), and had a high correlation with APACHE 鈪，
本文编号：2524246
[Abstract]:Objective: to investigate the value of IL-27 (IL-27) in the early diagnosis, severity and prognosis of sepsis. Methods: the patients with systemic inflammatory response syndrome (SRIS) admitted to the intensive care unit of Yixing people's Hospital affiliated to Jiangsu University from July 2014 to July 2015 were screened for infection (blood, sputum, urine culture and X-ray chest radiography). According to the 2012 international definition guidelines of sepsis, they were diagnosed as sepsis group and classified as sepsis group, and the rest were classified as SIRS group. According to the diagnostic criteria, sepsis patients were divided into sepsis, severe sepsis and septic shock. On the 1st and 7th day, the levels of IL-27 and procalcitonin (PCT) were measured. The differences of IL-27 and PCT between the two groups were analyzed. The ROC curve was drawn and the area (AUC) under the curve was calculated to judge its diagnostic value. The correlation between the two indexes and Apache II was calculated by Pearson correlation coefficient to evaluate its value in judging the severity of the patient's condition. The prognosis of sepsis group was investigated after 28 days follow-up. Results: there were 118 cases, including 75 cases in sepsis group and 43 cases in SRIS group. There were 53 cases of sepsis, 14 cases of severe sepsis and 8 cases of septic shock in sepsis group. The levels of IL-27 and PCT in sepsis group were significantly higher than those in SIRS group on the 1st and 7th day (P 0.05). The AUC of IL-27 was 0.745, the sensitivity and specificity were 66% and 72%, the AUC of PCT was 0.836, the sensitivity and specificity were 78%, and the sensitivity and specificity of 75%.IL-27 combined with PCT were 0.884%, 83%, respectively. The levels of 88%.IL-27 and PCT in septic shock group were significantly higher than those in sepsis group and severe sepsis group (P 0.05), and had a high correlation with APACHE 鈪，
本文编号：2524246
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