可溶性白细胞介素7受体联合其他生物标志物对急诊脓毒症的诊断价值  

Diagnostic value of soluble interleukin 7 receptor in combination with other biomarkers for emergency sepsis

作　　者：李桂仙 潘兴邦[3] 顾伟 Li Guixian;Pan Xingbang;Gu Wei(Emergency Medicine Teaching and Research Office,Hebei Medical University,Shijiazhuang 050017,China;Department of Critical Care Medicine,Baoding First Central Hospital,Baoding 071030,China;Department of Emergency Medicine,Chuiyangliu Hospital Affiliated to Tsinghua University,Beijing 100022,China)

机构地区：[1]河北医科大学急诊医学教研室,石家庄050017 [2]保定市第一中心医院重症医学科,保定071030 [3]清华大学附属垂杨柳医院急诊科,北京100022

出　　处：《中国医师杂志》2023年第3期388-392,共5页Journal of Chinese Physician

基　　金：北京市科技计划课题(Z221100007422129)。

摘　　要：目的探讨可溶性白细胞介素7受体(sIL-7R)联合其他生物标志物对急诊脓毒症的诊断价值。方法采用前瞻性研究方法,选择2020年12月至2022年6月清华大学附属垂杨柳医院及保定市第一中心医院的急诊患者102例,分为脓毒症组(80例)和非脓毒症组(22例),同期健康体检者20例为对照组,收集患者资料,完善相关生物标志物检查并记录数值。利用统计学方法,评估sIL-7R对于脓毒症的诊断意义,筛选出脓毒症相关重要指标,从而构建脓毒症早期诊断模型。结果脓毒症组白细胞介素6(IL-6)、C反应蛋白(CRP)、年龄、sIL-7R显著高于非脓毒症组及对照组(均P<0.01)。通过R语言统计软件,对比脓毒症及非脓毒症组,筛选出sIL-7R、年龄、CRP、IL-6为脓毒症诊断重要指标,绘制受试者工作特征(ROC)曲线,并计算其诊断脓毒症的曲线下面积(AUC)分别为0.759、0.622、0.716、0.640,而基于4个指标构建的诊断模型表现优于其他指标,AUC值达到0.869。sIL-7R诊断脓毒症的AUC大于其他3指标,而联合其他炎症指标明显高于四者的单一检测,对于脓毒症的早期诊断具有明显优势。结论sIL-7R是脓毒症早期诊断的一个良好生物学标志物,其联合年龄、CRP、IL-6可以更好地提高对脓毒症的早期诊断能力。Objective To investigate the diagnostic value of soluble interleukin 7 receptors(sIL-7R)in combination with other biomarkers for emergency sepsis.Methods A prospective study method was used to select 102 emergency patients from the Chuiyangliu Hospital affiliated to Tsinghua University and Baoding First Central Hospital from December 2020 to June 2022.They were divided into sepsis group(80 cases)and non-sepsis group(22 cases),and 20 healthy people in the same period were selected as the control group.The patient data were collected,the relevant biomarker examination was improved and the values were recorded.Using statistical methods,the significance of sIL-7R for the diagnosis of sepsis was assessed,and important indicators related to the presence of sepsis were also screened to construct a model for the early diagnosis of sepsis.Results The levels of interleukin-6(IL-6),C-reactive protein(CRP),age and sIL-7R in sepsis group were significantly higher than those in non-sepsis group and control group(all P<0.01).Further,the sIL-7R,age,CRP,and IL-6 were selected as important diagnostic indicators of sepsis by comparing the sepsis and non-sepsis groups using R-language statistical software.Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)for diagnosing sepsis of the four indexes were calculated as 0.759,0.622,0.716 and 0.640,respectively.The diagnostic model based on the four indexes performed better than other indexes,and the AUC value reached 0.869.The AUC of sIL-7R in the diagnosis of sepsis was higher than that of the other three indexes,and the detection of SIL-7R in combination with other inflammatory indexes was significantly higher than that of the four indexes,which had obvious advantages for the early diagnosis of sepsis.Conclusions sIL-7R is a good biological marker for the early diagnosis of sepsis,and its combination with age,CRP,and IL-6 can better improve the early diagnosis of sepsis.

关 键 词：脓毒症 可溶性白细胞介素7受体 生物标记 急救医学 

分 类 号：R459.7[医药卫生—急诊医学]