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sIL-2R、TNF-α 和 PCT 对合并严重多发腹部损伤的闭合性腹部损伤患者感染性休克的诊断价值。

Diagnostic Value of sIL-2R, TNF-α and PCT for Sepsis Infection in Patients With Closed Abdominal Injury Complicated With Severe Multiple Abdominal Injuries.

机构信息

Department of Clinical Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China.

Department of Laboratory Medicine, Jiaozuo Fifth People's Hospital, Jiaozuo, China.

出版信息

Front Immunol. 2021 Oct 22;12:741268. doi: 10.3389/fimmu.2021.741268. eCollection 2021.

Abstract

OBJECTIVE

We aimed to evaluate the diagnostic value of soluble interleukin-2 receptor (sIL-2R), tumor necrosis factor-α (TNF-α), procalcitonin (PCT), and combined detection for sepsis infection in patients with closed abdominal injury complicated with severe multiple abdominal injuries.

PATIENTS AND METHODS

One hundred forty patients with closed abdominal injury complicated with severe multiple abdominal injuries who were diagnosed and treated from 2015 to 2020 were divided into a sepsis group ( = 70) and an infection group ( = 70).

RESULTS

The levels of sIL-2R, TNF-α, and PCT in the sepsis group were higher than those in the infection group ( < 0.05). The receiver operating characteristic (ROC) curve showed that the areas under the ROC curve (AUCs) of sIL-2R, TNF-α, PCT and sIL-2R+TNF-a+PCT were 0.827, 0.781, 0.821, and 0.846, respectively, which were higher than those of white blood cells (WBC, 0.712), C-reactive protein (CRP, 0.766), serum amyloid A (SAA, 0.666), and IL-6 (0.735). The AUC of the three combined tests was higher than that of TNF-α, and the difference was statistically significant ( < 0.05). There was no significant difference in the AUCs of sIL-2R and TNF-α, sIL-2R and PCT, TNF-α and PCT, the three combined tests and sIL-2R, and the three combined tests and PCT ( > 0.05). When the median was used as the cut point, the corrected sIL-2R, TNF-α, and PCT of the high-level group were not better than those of the low-level group ( > 0.05). When the four groups were classified by using quantile as the cut point, the OR risk values of high levels of TNF-α and PCT (Q4) and the low level of PCT (Q1) after correction were 7.991 and 21.76, respectively, with statistical significance ( < 0.05).

CONCLUSIONS

The detection of sIL-2R, TNF-α, and PCT has good value in the diagnosis of sepsis infection in patients with closed abdominal injury complicated with severe multiple abdominal injuries. The high concentrations of PCT and TNF-α can be used as predictors of the risk of septic infection.

摘要

目的

评估可溶性白细胞介素-2 受体(sIL-2R)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)联合检测对合并严重多发腹外伤的闭合性腹部损伤患者发生脓毒症感染的诊断价值。

方法

选取 2015 年至 2020 年期间收治的 140 例合并严重多发腹外伤的闭合性腹部损伤患者,根据是否发生脓毒症感染分为脓毒症组(n=70)和感染组(n=70)。

结果

脓毒症组患者的 sIL-2R、TNF-α和 PCT 水平均高于感染组(P<0.05)。受试者工作特征(ROC)曲线显示,sIL-2R、TNF-α、PCT 及 sIL-2R+TNF-α+PCT 的 ROC 曲线下面积(AUC)分别为 0.827、0.781、0.821 和 0.846,均高于白细胞(WBC,0.712)、C 反应蛋白(CRP,0.766)、血清淀粉样蛋白 A(SAA,0.666)和白细胞介素-6(IL-6,0.735)。三项联合检测的 AUC 高于 TNF-α,差异有统计学意义(P<0.05)。sIL-2R 与 TNF-α、sIL-2R 与 PCT、TNF-α 与 PCT 三项联合检测与 sIL-2R、三项联合检测与 PCT 的 AUC 比较,差异均无统计学意义(P>0.05)。以中位数为切点时,高水平组校正后的 sIL-2R、TNF-α 和 PCT 无更好的诊断价值(P>0.05)。采用四分位数作为切点进行四分组时,校正后 TNF-α、PCT 高水平(Q4)和 PCT 低水平(Q1)的优势比(OR)风险值分别为 7.991 和 21.76,差异均有统计学意义(P<0.05)。

结论

检测 sIL-2R、TNF-α、PCT 对合并严重多发腹外伤的闭合性腹部损伤患者脓毒症感染的诊断具有较好的价值,PCT 和 TNF-α 浓度升高可作为脓毒症感染风险的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a08/8569904/928f9beb30b8/fimmu-12-741268-g001.jpg

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