Fraunberger Peter, Wang Ying, Holler Ernst, Parhofer Klaus G, Nagel Dorothea, Walli Autar K, Seidel Dietrich
Department of Clinical Chemistry, University Hospital Grosshadern, Munich, Germany.
Shock. 2006 Jul;26(1):10-2. doi: 10.1097/01.shk.0000215319.06866.bd.
To investigate the prognostic value of interleukin 6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) in critically ill patients during the first increase of fever, serum levels were measured in 38 patients admitted to intensive care unit of the Department of Medicine, Klinikum Grosshadern, University of Munich, immediately after increase of body temperature more than 38.3 degrees C. Ten healthy controls were also included for comparison. The onset of fever was accompanied by elevated circulating levels of all the 3 markers in comparison with healthy controls. However, only IL-6 levels were significantly higher (P < 0.05) in nonsurvivors (n = 21) compared with survivors. Sensitivity, specificity, positive, and negative predictive values calculated from median levels was higher for IL-6 compared with PCT and CRP. Areas under receiver characteristic operating curves revealed the highest area under the curve for IL-6 in contrast to PCT and CRP. These data suggest that IL-6 rather than PCT or CRP may be an early predictor of mortality in patients with onset of fever and identify patients, who need intensive monitoring to initiate appropriate therapy at an early stage.
为了研究白细胞介素6（IL-6）、降钙素原（PCT）和C反应蛋白（CRP）在危重症患者首次发热时的预后价值，对慕尼黑大学格罗斯哈登临床医院内科重症监护病房收治的38例体温升高超过38.3℃后立即入院的患者测定了血清水平。还纳入了10名健康对照者进行比较。与健康对照者相比，发热开始时所有这3种标志物的循环水平均升高。然而，与存活者相比，非存活者（n = 21）中仅IL-6水平显著更高（P < 0.05）。与PCT和CRP相比（根据中位数水平计算），IL-6的敏感性、特异性、阳性和阴性预测值更高。受试者工作特征曲线下面积显示，与PCT和CRP相比，IL-6的曲线下面积最大。这些数据表明，对于发热患者，IL-6而非PCT或CRP可能是死亡的早期预测指标，并可识别出需要加强监测以便在早期启动适当治疗的患者。
