Wunder C, Eichelbrönner O, Roewer N
Klinik und Poliklinik für Anästhesiologie, Bayerische Julius-Maximilians Universität Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany.
Inflamm Res. 2004 Apr;53(4):158-63. doi: 10.1007/s00011-003-1239-3. Epub 2004 Mar 18.
Prospective examination whether changes in interleukin (IL)-6, IL-10 or procalcitonin (PCT) concentrations correlate with poor outcome in patients with severe sepsis in comparison with APACHE III or SAPS II.
33 patients who fulfilled the criteria for severe sepsis have been included in the study. Blood samples were collected for cytokine and PCT determinations. The Acute Physiology, Age and Chronic Health Evaluation (APACHE) III score and the Simplified Acute Physiology Score (SAPS) II were calculated for 3 consecutive days.
14 out of 33 patients died of multiple organ failure. The areas under the ROC-curves for APACHE III and SAPS II indicated a poor discrimination between survivors and non-survivors. Plasma PCT and IL-10 concentrations were higher in non-survivors than in survivors. IL-6 levels showed no differences between groups. The multivariate analysis of the APACHE III, SAPS II, IL-10 and PCT data showed a significant relationship between APACHE III, PCT plasma levels and outcome.
The data suggest that non-surviving patients have higher PCT and IL-10 values. Only APACHE III score and PCT plasma levels correlated with a poor outcome. Therefore, routine measurements of plasma PCT concentrations might be helpful to improve the mortality risk prediction in patients with severe sepsis.
前瞻性研究与急性生理与慢性健康状况评分系统（APACHE）III或简化急性生理学评分（SAPS）II相比，白细胞介素（IL）-6、IL-10或降钙素原（PCT）浓度变化是否与严重脓毒症患者的不良预后相关。
33例符合严重脓毒症标准的患者纳入本研究。采集血样测定细胞因子和PCT。连续3天计算急性生理学与慢性健康状况评分系统（APACHE）III评分和简化急性生理学评分（SAPS）II。
33例患者中有14例死于多器官功能衰竭。APACHE III和SAPS II的ROC曲线下面积显示存活者和非存活者之间的区分能力较差。非存活者的血浆PCT和IL-10浓度高于存活者。两组间IL-6水平无差异。对APACHE III、SAPS II、IL-10和PCT数据进行多因素分析显示，APACHE III、PCT血浆水平与预后之间存在显著关系。
数据表明，非存活患者的PCT和IL-10值较高。只有APACHE III评分和PCT血浆水平与不良预后相关。因此，常规测定血浆PCT浓度可能有助于改善严重脓毒症患者的死亡风险预测。
