脓毒症患儿血液中IL-17、IL-10、IL-12p70和TNF-α水平及其预后价值  

Serum levels of IL⁃17,IL⁃10,IL⁃12p70 and TNF⁃αin children with sepsis and their prognostic value

作　　者：葛晓宁 莫庆仪[1] 梁桂明[1] 梁森全 马力忠[1] GE Xiaoning;MO Qingyi;LIANG Guiming;LIANG Senquan;MA Lizhong(Pediatric Intensive Care Unit,Boai Hospital of Zhongshan,Zhongshan,Guangdong,China,528400)

机构地区：[1]中山市博爱医院儿科重症监护室,广东中山528400

出　　处：《分子诊断与治疗杂志》2024年第9期1678-1682,共5页Journal of Molecular Diagnostics and Therapy

基　　金：广东省中山市科技计划项目(20113A069)。

摘　　要：目的探究脓毒症患儿血液中IL-17、IL-10、IL-12p70和TNF-α水平及其预后价值。方法分析2020年5月至2023年5月期间中山市博爱医院儿科重症监护室收治的124例脓毒症患儿临床相关资料,依据病情严重度分为脓毒性休克组(n=28)、严重脓毒症组(n=34)以及一般脓毒症组(n=62),另选取同期58名体检健康儿童作为健康组。比较四组血清白细胞介素(IL)-17、IL-10、IL-12p70以及肿瘤坏死因子-α(TNF-α)水平。另根据脓毒症患儿预后情况,分为预后良好组(n=92)与预后不良组(n=32)。比较两组一般临床资料及实验室指标,以单、多因素Logistic分析影响脓毒症患儿预后的相关因素,绘制受试者工作特征(ROC)曲线分析血清IL-17、IL-10、IL-12p70和TNF-α对脓毒症患儿预后不良的评估价值。结果IL-17、IL-10、IL-12p70及TNF-α水平比较,脓毒性休克组均>严重脓毒症组>一般脓毒症组>健康组,差异有统计学意义(F=1343.04、667.91、1155.44、1358.00,均P<0.05);预后良好组与预后不良组在儿童重症监护室时间、机械通气时间以及血清IL-17、IL-10、IL-12p70、TNF-α水平上的比较,差异有统计学意义(χ^(2)/t=6.978、6.511、5.417、6.321、7.227、6.723,均P<0.05);多因素分析结果表明,儿童重症监护室时间以及机械通气时间长,IL-17、IL-10、IL-12p70及TNF-α水平升高均为脓毒症患儿预后不良的独立危险因素(P<0.05);血清IL-17、IL-10、IL-12p70、TNF-α以及4者联合检测的ROC曲线面积分别为0.785、0.818、0.827、0.804以及0.971(P<0.05)。结论血清IL-17、IL-10、IL-12p70以及TNF-α水平均与脓毒症患儿病情严重程度及预后联系紧密,且四者联合检测对脓毒症患儿预后评估具备较高应用价值。Objective To investigate the levels of IL-17,IL-10,IL-12p70 and TNF-αin the blood of children with sepsis and their prognostic value.Methods The clinical data of 124 children with sep-sis admitted to the Pediatric Intensive Care Unit at Zhongshan Bóai Hospital from May 2020 to May 2023 were analyzed.Based on the severity of the disease,they were divided into the septic shock group(n=28),the se-vere sepsis group(n=34)and the general sepsis group(n=62).Additionally,58 healthy children from the same period were selected as the healthy group.Serum levels of interleukin-17,IL-10,IL-12p70,and tumor necrosis factor-α(TNF-α)were compared among the four groups.Based on the prognosis of the children with sepsis,they were further divided into a good prognosis group(n=92)and a poor prognosis group(n=32).A comparison of general clinical data and laboratory indicators was conducted between the two groups.Relevant factors affecting the prognosis of children with sepsis were analyzed using single and multiple logistic analysis.The evaluation value of serum IL-17,IL-10,IL-12p70,and TNF-αin predicting poor prognosis among chil-dren with sepsis was analyzed using ROC curve analysis.Results The levels of IL-17,IL-10,IL-12p70,and TNF-αwere higher in the septic shock group than in the severe sepsis group,the general sepsis group,and the healthy group,with statistical significance(F=1343.04,667.91,1155.44,1358.00,P<0.05).There was a significant difference between the good prognosis group and the poor prognosis group in the time spent in the intensive care unit,mechanical ventilation time and serum levels of IL-17,IL-10,IL-12p70,and TNF-α(χ^(2)/t=6.978,6.511,5.417,6.321,7.227,6.723).Multivariate analysis showed that a long time in the intensive care unit and mechanical ventilation,along with increased levels of IL-17,IL-10,IL-12p70,and TNF-αwere independent risk factors for poor prognosis in children with sepsis(P<0.05).The ROC curve areas of serum IL-17,IL-10,IL-12p70,TNF-α,and the combination of all four patients were 0.785,

关 键 词：白细胞介素-17 白细胞介素-12p70 肿瘤坏死因子-α 白细胞介素-10 脓毒症 

分 类 号：R720.597[医药卫生—急诊医学]