From the Department of Laboratory Medicine, Hangzhou First People's Hospital, Hangzhou, China.
Pediatr Infect Dis J. 2018 Aug;37(8):801-805. doi: 10.1097/INF.0000000000001904.
To discuss the clinical significance of interleukin (IL)-6 in the differential diagnosis of sepsis and its capability of differentiating the sepsis induced by Gram-negative bacteria from that induced by Gram-positive bacteria.
A total of 379 children with sepsis were involved in this study to form the case group, and their C-reactive protein (CRP), procalcitonin (PCT) and IL-6 levels before antibiotics and after recovery were checked. Receiver operating characteristic curve was applied to evaluate the significance of CRP, PCT and IL-6 in the differential diagnosis of sepsis and their capability of differentiating the sepsis induced by Gram-negative bacteria from that induced by Gram-positive bacteria.
When these 3 indicators were applied to the differential diagnosis of sepsis, the area under the curve (AUC) of IL-6, PCT and CRP was 0.881, 0.877 and 0.754, respectively. The combination of IL-6 and PCT presented highest diagnostic efficiency. CRP, PCT and IL-6 levels in children with sepsis induced by Gram-negative bacteria were significantly higher than those in children with sepsis induced by Gram-positive bacteria.
CRP, IL-6 and PCT are applicable to the differential diagnosis of sepsis and differentiating the sepsis induced by Gram-negative bacteria from Gram-positive bacteria. Appropriate combinations of these indicators are capable of increasing differential diagnosis efficiency. These indicators can be used as markers of antibiotics usage, but whether they can be used as markers to withdraw antibiotics is still needed to be observed.
探讨白细胞介素（IL）-6 在鉴别诊断脓毒症及其区分革兰阴性菌与革兰阳性菌所致脓毒症中的临床意义。
本研究纳入 379 例脓毒症患儿作为病例组，检测其抗生素使用前及恢复后的 C 反应蛋白（CRP）、降钙素原（PCT）和 IL-6 水平。采用受试者工作特征曲线评价 CRP、PCT 和 IL-6 在鉴别诊断脓毒症及区分革兰阴性菌与革兰阳性菌所致脓毒症中的意义。
这 3 项指标用于鉴别诊断脓毒症时，IL-6、PCT 和 CRP 的曲线下面积（AUC）分别为 0.881、0.877 和 0.754。IL-6 和 PCT 联合具有最高的诊断效率。革兰阴性菌所致脓毒症患儿的 CRP、PCT 和 IL-6 水平明显高于革兰阳性菌所致脓毒症患儿。
CRP、IL-6 和 PCT 可用于鉴别诊断脓毒症及区分革兰阴性菌与革兰阳性菌所致脓毒症，适当组合这些指标可提高鉴别诊断效率。这些指标可作为抗生素使用的标志物，但能否作为撤药的标志物仍有待观察。
