白介素-6、降钙素原和血清淀粉样蛋白A联合检测在脓毒症患者中的应用价值  

The application value of a combination detection of IL-6,PCT and SSA in diagnosing sepsis

作　　者：田广 钱少兵 沙艳萍 洪美丽 祁雷[1] TIAN Guang;QIAN Shaobing;SHA Yanping(Department of Emergency,Affiliated Hospital of Nantong University,Rugao Branch(Rugao Boai Hospital),Jiangsu,Nantong 226000,China)

机构地区：[1]南通大学附属医院如皋分院/如皋博爱医院急诊科,江苏省如皋市226500

出　　处：《河北医药》2024年第2期250-253,共4页Hebei Medical Journal

基　　金：南通市卫健委科研课题项目(编号:MB2021087)。

摘　　要：目的探讨白介素6(IL-6)、降钙素原(PCT)和血清淀粉样蛋白A(SAA)联合检测在脓毒症患者中的应用价值。方法选取脓毒症患者86例为观察组,其中脓毒症性休克32例(休克组),未发生休克患者为普通组(n=45),未发生脓毒症的普通感染患者87例作为对照组,检测患者的IL-6、PCT及SAA水平,采用受试者工作曲线(ROC)分析3项指标,探讨其在脓毒症患者中的应用价值。结果脓毒症组患者的IL-6、PCTSAA水平及APACHEⅡ评分、SOFA评分均高于对照组,差异均有统计学意义(P<0.05);休克组IL-6,PCT,SAA水平及APACHEⅡ评分、SOFA评分均高于普通组,差异有统计学意义(P<0.05);单用IL-6诊断脓毒症灵敏度为75.3%、特异度为65.7%、AUC值为0.763;单用PCT诊断脓毒症灵敏度为70.6%、特异度为78.2%、AUC值为0.787;单用SAA诊断脓毒症的灵敏度为73.45%、特异度为64.62%、AUC值为0.765;IL-6、PCT及SAA三者联合应用诊断脓毒症灵敏度为91.79%、特异度为96.98%、AUC值为0.931。结论IL-6,PCT,SAA联合检测对于早期诊断脓毒症,观察病情变化,判断预后有一定的运用价值。Objective To investigate the application value of a combination detection of interleukin-6(IL-6),procalcitonin(PCT)and serum amyloid A(SAA)in diagnosing sepsis.Methods Eighty-six sepsis patients were selected as the observation group,including 32 patients in the septic shock group and 45 without septic shock in the common group.A total of 87 patients with common infection without sepsis were included in the control group.IL-6,PCT and SAA levels were detected.TheiRdiagnostic value in sepsis patients was analyzed by the receiver operating characteristic(ROC)curve.Results IL-6,PCT and SAA levels,as well as the Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score and the Sequential Organ Failure Assessment(SOFA)score in the observation group were significantly higher than those of the control group(P<0.05),which were significantly higher in the septic shock group than those of common group(P<0.05).The area undeRthe curve(AUC)of IL-6,PCT and SAA alone in diagnosing sepsis was 0.763(sensitivity,75.3%;specificity,65.7%),0.787(sensitivity,70.6%;specificity,78.2%)and 0.765(sensitivity,73.45%;specificity,64.62%),respectively.The AUC of their combination detection in diagnosing sepsis was 0.931(sensitivity,91.79%;specificity,96.98%).Conclusion The combination detection of IL-6,PCT,and SAA has a certain application value for early diagnosis of sepsis,monitoring changes in the condition,and predicting the prognosis.

关 键 词：淀粉样蛋白A 降钙素原 白介素-6 脓毒症 

分 类 号：R459.7[医药卫生—急诊医学]