血清IL-6和TNF-α水平对糖尿病酮症酸中毒合并感染的诊断价值  

The diagnostic value of serum IL-6 and TNF-α levels in diabetic ketoacidosis complicated infection

作　　者：尹乐 单琨[2] 魏瑶 杨松[2] YIN Le;DAN Kun;WEI Yao;YANG Song(Laboratory of the Third Hospital of Chengde,Chengde,Hebei 067000;Laboratory of Baoding first Central Hospital,Baoding,Hebei 071000,China)

机构地区：[1]承德市第三医院检验科,河北承德067000 [2]保定市第一中心医院检验科,河北保定071000

出　　处：《热带医学杂志》2021年第11期1445-1448,共4页Journal of Tropical Medicine

基　　金：2019年度河北省医学科学研究课题计划(20190185)。

摘　　要：目的探究血清白介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平对糖尿病酮症酸中毒(DKA)合并感染的诊断价值。方法选取2018年5月-2020年5月承德市第三医院内分泌科、重症医学科、急诊ICU住院DKA患者作为研究对象,从中随机选择DKA合并感染及DKA未合并感染组各100例,另选取本院同期住院糖尿病患者无DKA、无感染患者50例作为对照组。收集DKA感染组患者感染部位样本进行细菌病原微生物培养并用全自动微生物分析系统进行菌种鉴定;采用酶联免疫吸附法(ELISA)检测三组患者血清IL-6、TNF-α的水平并进行比较分析。结果革兰阳性菌金黄色葡萄球菌、表皮葡萄球菌是导致DKA患者发生感染的主要病原菌,构成比分别为26.2%(33株)、16.7%(21株);与对照组相比,DKA感染组和DKA无感染组患者两种血清指标均上升;与DKA无感染组相比,DKA感染组患者血清IL-6、TNF-α指标均上升,差异有统计学意义(P<0.05);三组患者血清IL-6、TNF-α水平在治疗后均明显下降,差异有统计学意义(P均<0.05);ROC曲线分析结果中,IL-6、TNF-α以及IL-6联合TNF-α三种指标的ROC曲线下面积分别为0.686、0.673、0.738,在各指标取最佳临界值时灵敏度分别为64.0%、65.0%、84.0%,特异度分别为69.0%、64.0%、86.0%。结论血清IL-6、TNF-α水平在DKA合并感染患者中明显上升,两者对DKA合并感染的早期诊断与及时治疗有着一定的临床意义和较高的应用价值。Objective To study the diagnostic value of serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels in diabetic ketoacidosis(DKA)complicated infection.Methods From May 2018 to May 2020,patients with DKA in the Department of Endocrinology,Department of Critical Care Medicine,and Emergency ICU of Chengde Third Hospital were selected as the research subjects,and 100 cases in each of the DKA co-infection and DKA non-co-infection groups were randomly selected.In the same period,50 patients with diabetes without DKA and infection were used as the control group.Samples of infected parts of patients in the DKA infection group were collected for bacterial pathogenic microorganism cultivation and automatic microbial analysis system was used for bacterial species identification;enzyme-linked immunosorbent assay(ELISA)was used to detect and compare the levels of serum IL-6 and TNF-α in the three groups.Results Gram-positive Staphylococcus aureus,Staphylococcus epidermis were the main pathogens causing the infection of DKA patients,with the constituent ratios of 26.2%(33 strains),16.7%(21 strains),respectively.Compared with the control group,both serum indexes of DKA infected group and DKA uninfected group increased.Compared with the DKAfree group,the serum levels of IL-6 and TNF-α in the DKA-infected group were increased,with statistically significant difference(P<0.05).Serum levels of IL-6 and TNF-α in all three groups decreased significantly after treatment,with statistically significant differences(P<0.05).According to the ROC curve analysis results,the areas under the ROC curve for IL-6 and TNF-α and IL-6 combined TNF-α were 0.686,0.673 and 0.738,respectively.At the optimal critical value of each index,the sensitivities were 64.0%,65.0% and 84.0%,respectively,and the specificities were 69.0%,64.0% and86.0%,respectively.Conclusions Serum levels of IL-6 and TNF-α were significantly increased in patients with DKA coinfection.Serum levels of IL-6 and TNF-α had certain clinical significance and high applicat

关 键 词：白介素-6 肿瘤坏死因子-Α 糖尿病酮症酸中毒 感染 

分 类 号：R587.1[医药卫生—内分泌]