Department of Laboratory Medicine, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Laboratory Medicine, Jiaozuo Fifth People's Hospital, Jiaozuo, China.
Front Public Health. 2022 Jul 22;10:923457. doi: 10.3389/fpubh.2022.923457. eCollection 2022.
The purpose of this study is to determine the diagnostic value and net clinical benefit of interleukin-10 (IL-10), interleukin-17 (IL-17), procalcitonin (PCT), and combination tests in patients with sepsis, which will serve as a standard for sepsis early detection.
An investigation of 84 sepsis patients and 81 patients with local inflammatory diseases admitted to the ICU of Tongji University Hospital in 2021. In addition to comparing inter-group variability, indicators relevant to sepsis diagnosis and therapy were screened.
LASSO regression was used to examine PCT, WBC, CRP, IL-10, IFN-, IL-12, and IL-17. Multivariate logistic regression linked IL-10, IL-17, and PCT to sepsis risk. The AUC values of IL-10, IL-17, PCT, and the combination of the three tests were much higher than those of standard laboratory infection indicators. The combined AUC was greater than the sum of IL-10, IL-17, and PCT ( < 0.05). A clinical decision curve analysis of IL-10, IL-17, PCT, and the three combined tests found that the three combined tests outperformed the individual tests in terms of total clinical benefit rate. To predict the risk of sepsis using IL-10, IL-17, and PCT had an AUC of 0.951, and the model's predicted probability was well matched. An examination of the nomogram model's clinical value demonstrated a considerable net therapeutic benefit between 3 and 87%.
The IL-10, IL-17, and PCT tests all have a high diagnostic value for patients with sepsis, and the combination of the three tests outperforms the individual tests in terms of diagnostic performance, while the combined tests have a higher overall clinical benefit rate.
本研究旨在确定白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、降钙素原(PCT)及联合检测在脓毒症患者中的诊断价值和净临床获益,为脓毒症早期检测提供标准。
纳入 2021 年同济大学附属同济医院 ICU 收治的 84 例脓毒症患者和 81 例局部炎症性疾病患者,除了比较组间差异外,还筛选了与脓毒症诊断和治疗相关的指标。
采用 LASSO 回归分析 PCT、WBC、CRP、IL-10、IFN-γ、IL-12、IL-17,多元逻辑回归将 IL-10、IL-17、PCT 与脓毒症风险联系起来。IL-10、IL-17、PCT 及三者联合检测的 AUC 值均明显高于标准实验室感染指标。联合 AUC 值大于 IL-10、IL-17、PCT 三者之和(<0.05)。IL-10、IL-17、PCT 及三者联合检测的临床决策曲线分析发现,三者联合检测在总临床获益率方面优于单项检测。使用 IL-10、IL-17、PCT 预测脓毒症风险的 AUC 为 0.951,模型预测概率匹配良好。对列线图模型的临床价值进行检验,发现 3%~87%之间存在显著的净治疗效益。
IL-10、IL-17、PCT 检测对脓毒症患者均具有较高的诊断价值,三者联合检测在诊断性能方面优于单项检测,而联合检测具有更高的总体临床获益率。