炎症因子在老年脓毒性休克早期的改变及对预后的评估价值  

The value of peripheral inflammation factors in prognostic assessment for aged patients with septic shock

作　　者：罗钰[1] 曹权[1] 

机构地区：[1]江苏省人民医院重症医学科,江苏南京210029

出　　处：《中国实验诊断学》2017年第11期1912-1914,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的分析炎症因子在老年脓毒性休克早期的改变及对预后的评估价值。方法分析2014年1月至2016年12月在我院接受治疗的脓毒性休克患者的临床资料。依据患者明确诊断脓毒性休克后的治疗过程中是否死亡分为死亡组及存活组。共纳入观察组(存活组)41例,对照组(死亡组)45例。检测两组患者发病后24h内,外周血白介素-6(IL-6)、C-反应蛋白(CRP)、白介素-10(IL-10)及降钙素原(PCT)。结果死亡组患者外周血PCT、CRP及IL-6水平均显著高于存活组(P<0.01)。两组患者外周血IL-10水平无显著性差异(P>0.05)。ROC曲线分析显示,以56.71ng/L为截点值,IL-6预测脓毒性休克患者病死的敏感性为88.89%,特异性为80.49%,曲线下面积为0.866,优于CRP及PCT。死亡组患者外周血IL-6水平与PCT(r=0.788,P<0.01)及CRP(r=0.436,P<0.01)均呈现显著正相关关系。结论外周血炎症相关指标对老年脓毒性休克的预后判断有一定价值,其中IL-6的预测诊断价值较高。Objective Our study was aimed to analyze the value of peripheral inflammation factors in prognostic as- sessment for aged patients with septic shock. Methods Clinical data of aged patients with septic shock received treat ment at our hospital from 2014 to 2017 were analyzed. Patients were divided into two groups by whether suffered from decease after definite diagnostic,Group A：no; Group B.. yes. Peripheral inflammation factors were tested and compared between the two groups,including Interleukin-6 （IL-6）, C-reactive protein （CRP）, Interleukin-10 （IL-10） and procalci- tonin（PCT）. Results A total of 86 patients were analyzed,Group A 41 cases,Group B 45 cases. Group A patients had higher levels of CRP, IL-6 and PCT than these of Group B, the difference were statistically significant （P〈 0.01）. There was no significant difference of IL-10 between the two groups （P〉0.05）. ROC analysis showed that the IL-6 cut-off point value of 56.71 ng/L,as used for the prediction of decease for aged patients with septic shock,provided a sensitivity of 88.89 %, a specificity of 80.49 %, an AUC of 0. 866, better than these of CRP and PCT. Correlation analysis showed that, for Group A patients,the levels of IL-6 had significant positive correlation with CRP（r= 0. 436, P〈 0. 012） and PCT（r=0. 788,P〈0.01）. Conchlsion The level of IL-6 showed a good prognostic evaluation value for aged patients with septic shock.

关 键 词：脓毒性休克 炎症因子 老年 预后 重症监护 

分 类 号：R459.7[医药卫生—急诊医学]