脓毒性休克患者肿瘤坏死因子-α 白细胞介素-10与血清降钙素原动态变化相关关系研究

doi:10.3969/j.issn.1002-1949.2018.09.002

Chinese Journal of Critical Care Medicine

2018, Vol. 38

Issue (9): 757-760 DOI: 10.3969/j.issn.1002-1949.2018.09.002

The correlation research for dynamic changes of blood procalcitonin and Pro-and anti-inflammatory eytokines for septic shock patients

Su Ming-hua, Yang Peng， Song Meng-long， Zhang Xiao-hong

Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital， Chengdu 610072

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Abstract Objective To research the relationship between blood procalcitonin and Pro-and anti-inflammatory eytokines for septic shock patients in ICU，which those monitored with TNF-α、 IL-10 and PCT， and assess the significance for Clinical condition. Methods From January 2014 to January 2016，60 septic shock patients which were received in EICU were divided into the survival group and the death group. Measure target：the first, third, fifth, seventh day morning， Serum of 60 patients were collected，PCT was detected by immunochemiluminescence, TNF-α and IL-10 were measured by double antibody sandwich enzyme immunoassay(ELISA). Results Both of the two groups TNF-α were rised in early phase，and the third day reached the peak level，then gradual declined，the value of TNF- α(ng/L) on the first, third, fifth and 7 days of the survival group was 108.2±29.3,126.1±32.2,85.9±23.4,47.7±13.2, and the death group was 135.1±36.3,162.2±41.9,126.7±34.5,88.1±31.6， at the same time point, P values were 0.011, 0.005, 0.006 and 0.004, respectively, which were significantly higher in the death group than in the survival group. In both groups, IL-10 gradually increased and reached the peak level on the fifth day, then decreased significantly on the seventh day after survival, while the death group remained at a high level.The IL-10 value of the first, third, fifth and 7th days in the survival group (ng/L) was 42.1±13.5,53.9±17.1,69.8±17.7,38.2±13.1, and the death group was 53.4±15.8, 79.2±26.5,109.3±31.4,107.7±25.9， the P values were 0.008, 0.004, <0.001 and <0.001， which were all significantly higher in the death group than in the survival group, of which the survival group was compared with fifth, seventh days, the P value was 0.003, the death group was fifth, seventh days, and the P value was 0.36. The PCT value of first, third, fifth and seventh days in the survival group (μg/L) was 6.3±2.7,15.5±9.1,4.6±2.9,1.5±0.9. The death group was 11.8±5.6,43.5±17.9,42.7±19.8,45.1±18.2, and the same time point PCT was compared with the death group, and the P value <0.001 was significantly higher than that of the survival group； Correlation comparison：TNF-α, IL-10, PCT of the survival group were significant positive correlation between each other； The first and the third day of the death group， PCT/TNF-α, TNF-α/IL-10 were positive correlation，but the fifth and the seventh day were no relationship，moreover， PCT/IL-10 were positive correlation for every time point of the death group. Conclusion The early rise of TNF-α, IL-10 and PCT in patients with septic shock gradually declined, suggesting that the prognosis was good. On the contrary, the continuous elevation or maintenance of the high level did not decrease, especially the persistent high level of PCT and IL-10, which suggested that the critical prognosis was poor. There was a significant correlation between the three factors. The higher the value, the more severe the inflammatory reaction. The CO monitoring could reflect the severity of the disease.

Key words： Septic shock Pro-and anti-inflammatory eytokines Procalcitonin(PCT) Multiple organ dysfunction syndrome(MODS)

Corresponding Authors: Zhang Xiao-hong, E-mail:2653099978@qq.com

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Su Ming-hua,Yang Peng,Song Meng-long, et al. The correlation research for dynamic changes of blood procalcitonin and Pro-and anti-inflammatory eytokines for septic shock patients[J]. Chinese Journal of Critical Care Medicine, 2018, 38(9): 757-760.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2018.09.002 OR http://www.cnemergency.org.cn/EN/Y2018/V38/I9/757

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