脓毒症患者血清IL-1、IL-17的表达水平及其对预后的影响  

Expression levels of serum IL-1 and IL-17 in sepsis patients and their impact on prognosis

作　　者：张鼎昊 尹雪强 左雷 ZHANG Ding-hao;YIN Xue-qiang;ZUO Lei(Department of Otolaryngology,the First Afiliated Hospital of Xinjiang Medica University,Urumqi 830054,Xinjiang,China;不详)

机构地区：[1]新疆医科大学第一附属医院耳鼻喉科,新疆乌鲁木齐830054 [2]新疆医科大学第六附属医院检验科,新疆乌鲁木齐830000 [3]新疆医科大学第一附属医院重症医学科,新疆乌鲁木齐830054

出　　处：《广东医学》2023年第9期1121-1125,共5页Guangdong Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(2021D01C025)。

摘　　要：目的 观察脓毒症患者血清白细胞介素(IL)-1、IL-17的表达水平,并分析二者对预后的影响及预测效能。方法 回顾性分析收治的106例脓毒症患者的临床资料,收集患者基线资料,记录治疗前血清IL-1、IL-17水平,评估患者预后,采用回归分析检验治疗前血清IL-1、IL-17水平对脓毒症患者预后的影响,并分析治疗前血清IL-1、IL-17对脓毒症患者预后不良的预测效能。结果 106例脓毒症患者中,有12例预后不良,有94例预后良好。比较预后不良组与预后良好组基线资料后,经单因素、多因素logistic回归分析检验结果显示,有急性肾损伤、有感染性休克、序贯器官衰竭评分(SOFA)及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)高评分、IL-1及IL-17高水平是脓毒症患者预后不良的风险因子(OR>1,P<0.05);绘制受试者工作特征(ROC)曲线发现,血清IL-1、IL-17水平单项预测、联合预测及模型预测预后不良的ROC曲线下面积(AUC)均>0.70,均有一定预测价值,且联合预测及模型预测的AUC与单项预测的AUC相近,两指标预测脓毒症预后更简单易行。结论 脓毒症患者预后不良与多种因素有关,其中血清IL-1、IL-17水平可用于预测预后不良风险,可作为临床预测脓毒症患者预后的辅助手段。Objective To observe the expression levels of serum interleukin-1(IL-1)and interleukin-17(IL-17)in sepsis patients and analyze their influence on patient′s prognosis,as well as their predictive efficacy.Methods Clinical data from 106 sepsis patients were retrospectively analyzed.Baseline data were collected,and serum IL-1 and IL-17 levels before treatment were recorded.Patient′s outcomes were assessed.Regression analysis was used to examine the impact of pre-treatment serum IL-1 and IL-17 levels on sepsis patient′s prognosis.Additionally,the predictive efficacy of pre-treatment serum IL-1 and IL-17 levels for adverse sepsis patient′s outcomes was analyzed.Results Among the 106 sepsis patients,12 had adverse outcomes,and 94 had good outcomes.After comparing baseline data between the two outcome groups,single-factor and multi-factor logistic regression analysis indicated that the presence of acute kidney injury,septic shock,sequential organ failure assessment(SOFA)score,and acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,as well as high levels of IL-1 and IL-17,were risk factors for adverse prognosis in sepsis patients(OR>1,P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for single,combined,and model predictions of adverse outcomes based on serum IL-1 and IL-17 levels were all>0.70,indicating significant predictive value.Moreover,the AUC for combined and model predictions were similar to that of single predictions,making them more convenient for sepsis prognosis prediction.Conclusion Adverse prognosis in sepsis patients is associated with multiple factors,with serum IL-1 and IL-17 levels being predictive of the risk of adverse prognosis.These biomarkers could serve as auxiliary tools for clinical prediction of sepsis patient outcomes.

关 键 词：脓毒症 预后 白细胞介素-1 白细胞介素-17 急性肾损伤 感染性休克 

分 类 号：R631.2[医药卫生—外科学] R392.7[医药卫生—临床医学]