白介素-18和急性生理及慢性健康状况评分Ⅱ及序贯器官功能衰竭估计评分对早期脓毒症预后的评估价值分析  

Values of Interleukin 18,APACHEⅡ and SOFA Score in the Evaluation of Prognosis of Early Sepsis

作　　者：张少雷[1] 孙荣青[1] 杨宏富[1] 马宁 熊申明[1] 

机构地区：[1]为郑州大学第一附属医院ICU,河南省郑州市450052

出　　处：《中国全科医学》2011年第14期1605-1607,共3页Chinese General Practice

摘　　要：目的检测和记录脓毒症早期患者白介素(IL)-18、急性生理及慢性健康状况评分(APACHE)Ⅱ及序贯器官功能衰竭评分(SOFA),评价三者对脓毒症早期预后的评估价值。方法选取38例重症监护病房(ICU)内脓毒症早期患者为脓毒症组,同期住院的20例非脓毒症患者为对照组。根据28 d生存情况分为生存和死亡两种结局。记录患者入选后24 h、48 h、72 h的临床资料,评价APACHEⅡ和SOFA评分,用ELISA法检测血清IL-18。判断其对预后的评估价值。结果脓毒症组患者确诊后24 h、48 h、72 h时IL-18水平和SOFA评分间均明显高于对照组,差异均有统计学意义(P<0.05)。且随疾病进展,IL-18水平呈下降趋势。两组患者APACHEⅡ在各时间点间差异无统计学意义(P>0.05)。脓毒症患者亚组分析,死亡组IL-18水平、APAHCEⅡ和SOFA评分均明显高于存活组,差异有统计学意义(P<0.05)。结论 IL-18在脓毒症早期表达升高,可以反映疾病进展程度。IL-18与APAHCEⅡ和SOFA评分对脓毒症的预后判断价值相似,可以作为早期脓毒症预后的预测指标。Objective To determine the serum interleukin（IL） 18 levels,APACHEⅡ score,and SOFA score in patients with early sepsis and to access their values in pridicting the prognosis.Methods Thirty-eight patients with early spesis from the intensive care unit（ICU） were erolled as the sepsis group,with another twenty who were hospitalized during the same period with non-sepsis conditions as the control group.Tow end-points was defined as survival and death,according to the living status on day 28.Clinical data were recorded 24h,48h,and 72h after erollement respectively,with APACHEⅡ score and SOFA score calculated and.IL-18 levels determined by ELISA.AUC（Area Under roc Curve） of the 3 variables were calculated with their values in predicting the prognosis accessed.Results Serum IL-18 levels and SOFA score in the sepsis group were significantly higher（P0.05） than in the control group 24h,48h,72h after diagnosed respectively,with IL-18 levels decreased along with the process of the disease.There were no significant differences in APACHEⅡ score between the two groups（P0.05）.Serum IL-18 levels,APACHEⅡ score and SOFA score were significantly higher among the death patients according to analysis within the sepsis group（P0.05）.Conclusion Levels of serum IL-18,which elevated in the early stage of sepsis,may reflect the progress of the disease.IL-18,APACHEⅡ score,and SOFA score,with prediction values alike,might be used as indicators of prognosis of early sepsis.

关 键 词：脓毒症 白介素18 急性生理与慢性健康状况评分 序贯器官功能衰竭评分 预后 

分 类 号：R59[医药卫生—内科学]