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白细胞介素-6在急诊科脓毒症患者中的诊断及预后价值

Diagnostic and Prognostic Value of Interleukin-6 in Emergency Department Sepsis Patients.

作者信息

Yu Baozhong, Chen Maolin, Zhang Ye, Cao Yudan, Yang Jun, Wei Bing, Wang Junyu

机构信息

Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, & Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Clinical Center for Medicine in Acute Infection, Capital Medical University, Beijing, People's Republic of China.

出版信息

Infect Drug Resist. 2022 Sep 21;15:5557-5566. doi: 10.2147/IDR.S384351. eCollection 2022.

Abstract

PURPOSE

The objective of this study was to explore the diagnostic and prognostic value of interleukin-6 (IL-6) in sepsis patients presenting to the emergency department.

PATIENTS AND METHODS

A total of 128 patients who visited the emergency department of West Hospital of Beijing Chaoyang Hospital, affiliated to Capital Medical University, from November 2021 to February 2022 were subjected to this study. According to Sepsis-3.0 diagnostic criteria for sepsis, patients were divided into non-sepsis group (65 cases) and sepsis group (63 cases). Demographic data and clinical characteristics of the two patient groups were compared. Serum levels of biomarkers including IL-6, blood urea nitrogen (BUN), and lactic acid (Lac) were compared with Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Scale (GCS) scores. Logistic regression was used to analyze independent risk factors and Receiver Operating Characteristic Curve (ROC) method was used to analyze the Area Under the Curve (AUC) to determine the diagnostic and prognostic value of markers.

RESULTS

Compared with non-sepsis patients, levels of IL-6, PCT, CRP and BUN were significantly higher in sepsis patients (10.84 (4.41-27.01): 92.22 (21.53-201.12), 0.03 (0.01-0.1):0.49 (0.08-3.1), 8.3 (0.5-31.8):39.8(10.3-98.6), 7.01 (4.90-11.74):13.03 (6.93-25.99), all = 0.001). IL-6, BUN and mean arterial pressure (MAP) were independent risk factors for sepsis diagnosis. AUC values of IL-6, BUN, MAP and IL-6+BUN+MAP were 0.764, 0.696, 0.685, and 0.848, respectively. Lactate, age and SOFA score were independent risk factors for 28-day mortality in sepsis patients. The AUC of Lac, age, SOFA score and Lac+age+SOFA score to predict 28-day death in sepsis patients was 0.679, 0.626, 0.747, and 0.819, respectively.

CONCLUSION

IL-6 is an independent predictor of sepsis diagnosis, and the combination of blood BUN and MAP has superior diagnostic performance. Lac, age, and SOFA score could effectively predict clinical outcomes in patients with sepsis.

摘要

目的

本研究旨在探讨白细胞介素-6(IL-6)在急诊科脓毒症患者中的诊断及预后价值。

患者与方法

选取2021年11月至2022年2月就诊于首都医科大学附属北京朝阳医院西院急诊科的128例患者纳入本研究。根据脓毒症的Sepsis-3.0诊断标准,将患者分为非脓毒症组(65例)和脓毒症组(63例)。比较两组患者的人口统计学数据及临床特征。将包括IL-6、血尿素氮(BUN)和乳酸(Lac)在内的生物标志物血清水平与序贯器官衰竭评估(SOFA)及格拉斯哥昏迷量表(GCS)评分进行比较。采用逻辑回归分析独立危险因素,运用受试者工作特征曲线(ROC)法分析曲线下面积(AUC)以确定标志物的诊断及预后价值。

结果

与非脓毒症患者相比,脓毒症患者的IL-6、降钙素原(PCT)、C反应蛋白(CRP)和BUN水平显著更高(10.84(4.41 - 27.01):92.22(21.53 - 201.12),0.03(0.01 - 0.1):0.49(0.08 - 3.1),8.3(0.5 - 31.8):39.8(10.3 - 98.6),7.01(4.90 - 11.74):13.03(6.93 - 25.99),均P = 0.001)。IL-6、BUN和平均动脉压(MAP)是脓毒症诊断的独立危险因素。IL-6、BUN、MAP以及IL-6 + BUN + MAP的AUC值分别为0.764、0.696、0.685和0.848。乳酸、年龄和SOFA评分是脓毒症患者28天死亡率的独立危险因素。Lac、年龄、SOFA评分以及Lac + 年龄 + SOFA评分预测脓毒症患者28天死亡的AUC分别为0.679、0.626、0.747和0.819。

结论

IL-6是脓毒症诊断的独立预测指标,血BUN与MAP联合具有更好的诊断性能。Lac、年龄和SOFA评分可有效预测脓毒症患者的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd6a/9512288/174acdedf96b/IDR-15-5557-g0001.jpg

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