Department of Medical Biochemistry, Wroclaw Medical University, Chalubinskiego 10, 50-368 Wroclaw, Poland.
Department of Anesthesiology and Intensive Therapy, 4th Military Hospital of Wroclaw, Weigla 5, 50-981 Wroclaw, Poland; Department of Pathophysiology, Wroclaw Medical University, Marcinkowskiego 1, 50-368 Wroclaw, Poland.
Cytokine. 2019 Aug;120:22-27. doi: 10.1016/j.cyto.2019.04.003. Epub 2019 Apr 16.
Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection and a syndrome shaped by pathogen and host factors with characteristic that evolve over time. The study was conducted to evaluate the prognostic and discriminative value of IL-18 assessment in comparison to PCT, CRP, WBC in early stage of sepsis and septic shock.
An observational and prospective study was conducted in the group of 40 ICU patients with diagnosis of sepsis or septic shock, serum PCT, IL-18, CRP and WBC measurements were performed on admission, and on the 2nd, 3rd and 5th therapy day. The level of IL-18 was determined with commercially available test according to manufacturer's protocol.
There were no statistically significant differences in IL-18 levels in survivors vs non-survivors and in sepsis vs septic shock subgroups the IL-18 levels were statistically significant in the course of the study except for the 5th day.
The PCT, CRP and WBC levels revealed no significant differences between any analyzed subgroups in all time points during study. According to our results the IL-18 is a biomarker better differentiating sepsis and septic shock status than PCT, CRP and WBC but with no prognostic impact.
脓毒症是一种危及生命的器官功能障碍,由宿主对感染的失调反应引起,其特征是病原体和宿主因素共同作用,并随时间演变。本研究旨在评估白细胞介素 18(IL-18)评估与降钙素原(PCT)、C 反应蛋白(CRP)、白细胞计数(WBC)在脓毒症和感染性休克早期的预后和鉴别价值。
对 40 例 ICU 中诊断为脓毒症或感染性休克的患者进行观察性和前瞻性研究,在入院时以及治疗的第 2、3 和 5 天检测血清 PCT、IL-18、CRP 和 WBC。IL-18 水平根据制造商的方案,使用市售试剂盒进行测定。
在存活者与非存活者之间以及在脓毒症与感染性休克亚组之间,IL-18 水平在研究过程中除第 5 天外均无统计学差异。
在研究期间的所有时间点,PCT、CRP 和 WBC 水平在任何分析的亚组之间均无显著差异。根据我们的结果,IL-18 是一种比 PCT、CRP 和 WBC 更好地区分脓毒症和感染性休克状态的生物标志物,但没有预后影响。