Yang Jiangang, Yang Yubin, Liu Qinghua
Department of Pathophysiology, Shanxi Medical University, Taiyuan 030001, Shanxi, China.
Department of ICU, the Third People's Hospital of Datong, Datong 037000, Shanxi, China. Corresponding author: Liu Qinghua, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019 Jun;31(6):680-683. doi: 10.3760/cma.j.issn.2095-4352.2019.06.004.
To explore the correlation between major inflammatory factors and septic shock in intensive care unit (ICU) patients, and to provide a basis for the diagnosis and treatment of septic shock.
The patients admitted to ICU of the Third People's Hospital of Datong from March 2017 to August 2018 were selected as the research objects. According to the diagnostic criteria of septic shock, the patients were divided into septic shock group and non-septic group. The basic information and inflammatory factors levels of the two groups, including age, gender, body mass index (BMI), course of disease, acute physiology and chronic health evaluation II (APACHE II), infection site and pathogenic; and C-reactive protein (CRP), procalcitonin (PCT), neutrophil lymphocyte ratio (NLR), N-terminal pro-B-type natriuretic peptide (NT-proBNP), tumor necrosis factor-α (TNF-α), γ-interferon (IFN-γ), interleukins (IL-1β, IL-2, IL-6, IL-8) at 8 hours after diagnosis, were compared. Logistic regression was used to analyze the influencing factors of septic shock in ICU patients.
A total of 154 ICU patients were selected, of whom 74 had septic shock. The APACHE II score of septic shock group was significantly higher than that of non-sepsis group (23.42±3.64 vs. 15.67±2.26, P < 0.05). There was no significant difference in other baseline data between the two groups. The levels of CRP, NT-proBNP, TNF-α, IFN-γ, PCT, IL-6, IL-8 in the septic shock group were significantly higher than those in the non-septic group [CRP (mg/L): 164.3±22.6 vs. 52.3±16.2, NT-proBNP (ng/L): 426.3±288.9 vs. 167.3±80.6, TNF-α (ng/L): 193.4±39.3 vs. 88.1±20.3, IFN-γ (ng/L): 133.3±52.0 vs. 97.0±56.1, PCT (ng/L): 27.6±10.2 vs. 7.3±4.1, IL-6 (ng/L): 83.0±17.6 vs. 20.9±6.4, IL-8 (ng/L): 445.8±34.0 vs. 84.0±25.7, all P < 0.05]. It was shown by Logistic regression analysis that CRP, NT-proBNP, TNF-α, PCT, IL-6 were independent risk factors for septic shock [CRP: odds ratio (OR) = 1.662, 95% confidence interval (95%CI) = 1.132-2.567; NT-proBNP: OR = 14.688, 95%CI = 3.580-20.238; TNF-α: OR = 1.093, 95%CI = 1.043-1.343; PCT: OR = 6.378, 95%CI = 4.556-12.243; IL-6: OR = 9.641, 95%CI = 2.242-13.786; all P < 0.05].
The levels of inflammatory factors CRP, NT-proBNP, TNF-α, PCT and IL-6 were significantly increased, which were important factors for early diagnosis of septic shock.
探讨重症监护病房（ICU）患者主要炎症因子与感染性休克的相关性，为感染性休克的诊治提供依据。
选取2017年3月至2018年8月大同市第三人民医院ICU收治的患者作为研究对象。根据感染性休克的诊断标准，将患者分为感染性休克组和非感染组。比较两组患者的基本信息及炎症因子水平，包括年龄、性别、体重指数（BMI）、病程、急性生理与慢性健康状况评分系统II（APACHE II）、感染部位及病原菌；以及诊断后8小时的C反应蛋白（CRP）、降钙素原（PCT）、中性粒细胞淋巴细胞比值（NLR）、N末端B型利钠肽原（NT-proBNP）、肿瘤坏死因子-α（TNF-α）、γ干扰素（IFN-γ）、白细胞介素（IL-1β、IL-2、IL-6、IL-8）。采用Logistic回归分析ICU患者感染性休克的影响因素。
共选取154例ICU患者，其中74例发生感染性休克。感染性休克组的APACHE II评分显著高于非感染组（23.42±3.64比15.67±2.26，P<0.05）。两组其他基线数据差异无统计学意义。感染性休克组的CRP、NT-proBNP、TNF-α、IFN-γ、PCT、IL-6、IL-8水平显著高于非感染组[CRP（mg/L）：164.3±22.6比52.3±16.2，NT-proBNP（ng/L）：426.3±288.9比167.3±80.6，TNF-α（ng/L）：193.4±39.3比88.1±20.3，IFN-γ（ng/L）：133.3±52.0比97.0±56.1，PCT（ng/L）：27.6±10.2比7.3±4.1，IL-6（ng/L）：83.0±17.6比20.9±6.4，IL-8（ng/L）：445.8±34.0比84.0±25.7，均P<0.05]。Logistic回归分析显示，CRP、NT-proBNP、TNF-α、PCT、IL-6是感染性休克的独立危险因素[CRP：比值比（OR）=1.662，95%置信区间（95%CI）=1.132-2.567；NT-proBNP：OR=14.688，95%CI=3.580-20.238；TNF-α：OR=1.093，95%CI=1.043-1.343；PCT：OR=6.378，95%CI=4.556-12.243；IL-6：OR=9.641，95%CI=2.242-13.786；均P<0.05]。
炎症因子CRP、NT-proBNP、TNF-α、PCT及IL-6水平显著升高，是感染性休克早期诊断的重要因素。
