系统免疫炎症指数联合细胞因子检测在脓毒血症患者中的应用  

The Application of Systemic Immune Inflammation Index Combined with Cytokine Detection in Patients with Sepsis

作　　者：郑岚[1] 石慧[1] 姚晓玲[1] 杨晓双[1] 郑浩[1] ZHENG Lan;SHI Hui;YAO Xiaoling;YANG Xiaoshuang;ZHENG Hao(The Third People’s Hospital of Bengbu,Bengbu 233000,China)

机构地区：[1]蚌埠市第三人民医院检验科,安徽蚌埠233000

出　　处：《标记免疫分析与临床》2024年第5期855-859,共5页Labeled Immunoassays and Clinical Medicine

基　　金：蚌埠市科技局创新指导类项目(编号:20220120)。

摘　　要：目的探讨系统免疫炎症指数(SII)联合细胞因子检测在脓毒血症患者中的应用。方法研究对象为某院2022年9月至2023年12月收治的感染患者117例,根据感染严重程度将患者分为3组,脓毒血症组40例,重症感染组32例和普通感染组45例(非脓毒血症患者),对比不同患者体重指数BMI、感染部位、基础疾病等一般临床资料和SII、IL-6、IL-8等实验室指标。采用多因素Logistic回归筛选脓毒血症发生的影响因素,构建相应的预测模型,评估SII、IL-6和IL-8在脓毒血症诊断中的应用价值。结果普通感染组、重症感染组及脓毒血症组SII、IL-6、IL-8水平逐渐增高,且差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,SOFA评分、APACHE-II评分、SII、IL-6、IL-8为脓毒血症发生的独立危险因素(P<0.05),脓毒血症患者BMI、SOFA评分、APACHE-II评分高于非脓毒血症患者(P<0.05)。IL-8是诊断脓毒血症最强的独立危险因子。联合SII、IL-6、IL-83种指标构建的预测模型,具有更高的灵敏度、特异性及更高的ROC曲线下面积AUC(90.00%、91.20%、0.914),均比SII、IL-6及IL-83项单独检测时高。结论SII、IL-6和IL-8指标可以判定感染的严重程度,且是脓毒血症诊断的独立危险因素。3者联合检测可以提高脓毒血症早期诊断效率,及时干预从而改善患者预后。Objective To explore the usage of systemic immune-inflammation index(SII)and combined cytokine detection in patients with sepsis.Methods A total of 117 infection patients admitted to a hospital from September,2022 to December,2023 were enrolled in this study.According to the severity of infections,these patients were divided into three groups:sepsis group(40 cases),severe infection group(32 cases)and common infection group(45 cases).General clinical data such as body mass index(BMI),infection site,underlying disease and laboratory indicators such as SII,IL-6,and IL-8 were compared among different patient groups.Multivariate logistic regression was applied to screen potential influencing factors of sepsis,and the corresponding prediction model was constructed to evaluate the application value of SII,IL-6 and IL-8 in the diagnosis of sepsis.Results Levels of SII,IL-6 and IL-8 in the common infection group,the severe infection group,and the sepsis group gradually increased,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that SOFA score,APACHE-II score,SII,IL-6 and IL-8 were independent risk factors for sepsis(P<0.05).BMI,SOFA score and APACHE-II score in patients with sepsis were higher than those in patients without sepsis(P<0.05).IL-8 was identified as the strongest independent risk factor for diagnosing sepsis.The prediction model constructed by combining SII,IL-6 and IL-8 had higher sensitivity,specificity and bigger area under the ROC curve(AUC:90.00%,91.20%and 0.914),which were all higher than those of SII,IL-6 and IL-8 individually.Conclusion SII,IL-6,and IL-8 can be used to determine the severity of infection and are independent risk factors for the diagnosis of sepsis.The combined detection of these three markers can improve the efficiency of the early diagnosis of sepsis and timely intervention,thereby improving the prognosis of patients.

关 键 词：脓毒血症 系统免疫炎症指数 细胞因子 

分 类 号：R631[医药卫生—外科学]