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白细胞介素6水平对重症脓毒症患者急性肺损伤风险及疾病严重程度的影响。

Impact of interleukin 6 levels on acute lung injury risk and disease severity in critically ill sepsis patients.

作者信息

Liu Ya, Chen Li

机构信息

Department of Intensive Care Unit, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201900, China.

出版信息

World J Clin Cases. 2024 Aug 16;12(23):5374-5381. doi: 10.12998/wjcc.v12.i23.5374.

Abstract

BACKGROUND

Sepsis is a life-threatening condition characterized by a dysregulation of the host response to infection that can lead to acute lung injury (ALI) and multiple organ dysfunction syndrome (MODS). Interleukin 6 (IL-6) is a pro-inflammatory cytokine that plays a crucial role in the pathogenesis of sepsis and its complications.

AIM

To investigate the relationship among plasma IL-6 levels, risk of ALI, and disease severity in critically ill patients with sepsis.

METHODS

This prospective and observational study was conducted in the intensive care unit of a tertiary care hospital between January 2021 and December 2022. A total of 83 septic patients were enrolled. Plasma IL-6 levels were measured upon admission using an enzyme-linked immunosorbent assay. The development of ALI and MODS was monitored during hospitalization. Disease severity was evaluated by Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores.

RESULTS

Among the 83 patients with sepsis, 38 (45.8%) developed ALI and 29 (34.9%) developed MODS. Plasma IL-6 levels were significantly higher in patients who developed ALI than in those without ALI (median: 125.6 pg/mL 48.3 pg/mL; < 0.001). Similarly, patients with MODS had higher IL-6 levels than those without MODS (median: 142.9 pg/mL 58.7 pg/mL; < 0.001). Plasma IL-6 levels were strongly and positively correlated with APACHE II ( = 0.72; < 0.001) and SOFA scores ( = 0.68; < 0.001).

CONCLUSION

Elevated plasma IL-6 levels in critically ill patients with sepsis were associated with an increased risk of ALI and MODS. Higher IL-6 levels were correlated with greater disease severity, as reflected by higher APACHE II and SOFA scores. These findings suggest that IL-6 may serve as a biomarker for predicting the development of ALI and disease severity in patients with sepsis.

摘要

背景

脓毒症是一种危及生命的病症,其特征为宿主对感染的反应失调,可导致急性肺损伤(ALI)和多器官功能障碍综合征(MODS)。白细胞介素6(IL-6)是一种促炎细胞因子,在脓毒症及其并发症的发病机制中起关键作用。

目的

探讨脓毒症重症患者血浆IL-6水平、ALI风险与疾病严重程度之间的关系。

方法

这项前瞻性观察性研究于2021年1月至2022年12月在一家三级护理医院的重症监护病房进行。共纳入83例脓毒症患者。入院时采用酶联免疫吸附测定法测量血浆IL-6水平。住院期间监测ALI和MODS的发生情况。采用急性生理与慢性健康状况评分系统II(APACHE II)和序贯器官衰竭评估(SOFA)评分评估疾病严重程度。

结果

83例脓毒症患者中,38例(45.8%)发生ALI,29例(34.9%)发生MODS。发生ALI的患者血浆IL-6水平显著高于未发生ALI的患者(中位数:125.6 pg/mL对48.3 pg/mL;P<0.001)。同样,发生MODS的患者IL-6水平高于未发生MODS的患者(中位数:142.9 pg/mL对58.7 pg/mL;P<0.001)。血浆IL-6水平与APACHE II评分(r=0.72;P<0.001)和SOFA评分(r=0.68;P<0.001)呈强正相关。

结论

脓毒症重症患者血浆IL-6水平升高与ALI和MODS风险增加相关。较高的IL-6水平与更高的疾病严重程度相关,这由更高的APACHE II和SOFA评分反映出来。这些发现表明,IL-6可能作为预测脓毒症患者ALI发生和疾病严重程度的生物标志物。

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