血清IL-6、PCT水平在ARDS预后中的预测价值  

Predictive Value of Serum IL-6 and PCT Levels in the Prognosis of ARDS

作　　者：邓晶 史家欣 DENG Jing;SHI Jiaxin(Department of Pulmonary and Critical Care Medicine,The Affiliated Lianyungang Hospital of Xuzhou Medical University,Jiangsu 222000,China)

机构地区：[1]徐州医科大学附属连云港医院呼吸与危重症医学科,222000 [2]扬州大学附属医院呼吸与危重症医学科,225012

出　　处：《医学研究杂志》2025年第2期77-81,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(81300052);江苏省社会发展面上项目(BE2020670)。

摘　　要：目的探讨白细胞介素-6(interleukin-6,IL-6)和降钙素原(procalcitonin,PCT)水平对急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者预后的预测价值。方法选取2021年1月~2023年12月徐州医科大学附属连云港医院收治的99例ARDS患者为研究对象,根据柏林定义将其分为轻度组(n=22)、中度组(n=42)和重度组(n=35),根据其28天转归情况分为生存组(n=65)及死亡组(n=34)。比较各组IL-6、PCT的水平,通过受试者工作特征(receiver operator characteristic,ROC)曲线和曲线下面积(area under the curve,AUC)评估两者在ARDS患者预后中的预测价值。绘制不同IL-6、PCT水平ARDS患者的Kaplan-Meier生存曲线。结果3种不同病情严重程度的ARDS患者中,重度组的IL-6、PCT水平最高,中度组次之,轻度组最低,各组间比较差异均有统计学意义(P<0.05);死亡组患者IL-6、PCT水平明显高于生存组,差异有统计学意义(P<0.05)。IL-6和PCT评价ARDS患者预后的AUC分别为0.793、0.776,敏感度分别为79.4%、94.1%,特异性分别为70.8%、61.5%。Kaplan-Meier生存曲线分析结果显示,IL-6≥110.700pg/ml和PCT≥1.700ng/ml时,ARDS患者28天存活率较IL-6<110.700pg/ml和PCT<1.700ng/ml者显著降低(P<0.001)。结论PCT、IL-6水平对预测ARDS患者的短期预后具有良好价值,可作为评估ARDS患者预后的有效指标。Objective To investigate the predictive value of serum interleukin-6(IL-6)and procalcitonin(PCT)levels on the prognosis of patients with acute respiratory distress syndrome(ARDS).Methods A total of 99 ARDS patients admitted to Lianyungang Hospital affiliated to Xuzhou Medical University from January 2021 to December 2023 were included in the study.According to the Berlin definition,the patients were divided into mild group(n=22),moderate group(n=42)and severe group(n=35)groups.Based on their 28-day outcomes,they were also divided into survival group(n=65)and death group(n=34).The levels of IL-6 and PCT in each group were compared.The predictive value of IL-6 and PCT for the prognosis of ARDS patients was analyzed using receiver operating characteristic(ROC)curve and the area under the curve(AUC).The Kaplan-Meier method was used to plot survival curves for ARDS patients with different levels of IL-6 and PCT.Results Among the three groups with varying severity of ARDS,the severe group had the highest IL-6 and PCT levels,followed by the moderate group,and the mild group had the lowest levels.The differences among the groups were statistically significant(P<0.05).The levels of IL-6 and PCT in the death group were significantly higher than those in the survival group,and the difference was statistically significant(P<0.05).The AUC of IL-6 and PCT in predicting the prognosis of ARDS patients were 0.793 and 0.776,with the sensitivity of 79.4%and 94.1%,and the specificity of 70.8%and 61.5%,respectively.Kaplan-Meier survival curve analysis showed that when IL-6 was≥110.700pg/ml and PCT was≥1.700ng/ml,the 28-day survival rate of ARDS patients was significantly lower than that of patients with IL-6<110.700pg/ml and PCT<1.700ng/ml(P<0.001).Conclusion PCT and IL-6 levels have good value in predicting the short-term prognosis of ARDS patients,and can be used as effective indicators for prognosis evaluation in ARDS patients.

关 键 词：急性呼吸窘迫综合征 IL-6 PCT 预后 预测价值 

分 类 号：R563[医药卫生—呼吸系统]