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| Clinical value on evaluation of illness state and prognosis by serum IL-18/IL-35 combined with PCT in patients with sepsis |
| Zhu Zhi-xia, Xu Zhen-wei, Huang Yan-long, Ye Zhi-ming, Xie Jian-li |
| Department of Emergency, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, China |
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Abstract Objective To explore the application of serum IL-18/IL-35 combined with procalcitonin (PCT) on evaluation of illness state and prognosis in patients with sepsis. Methods 120 patients with sepsis were selected and set as group A, and they were subdivided into group A1 (sepsis), group A2 (severe sepsis) and group A3 (septic shock) according to the severity. 30 healthy volunteers were selected and set as group B. Serum IL-18, IL-35 and PCT were tested in 12 hours after the diagnosis of sepsis in group A and on the day of physical examination in group B, and IL-18/IL-35 was calculated. The prognosis of patients within 28 days was recorded, and they were subdivided into group Ax (survival) and group Ay (death associated with sepsis). Serum levels of IL-18, IL-35, IL-18/IL-35 and PCT were compared between the groups and the correlation between the indicators was analyzed, and the ROC curve was used to compare the diagnostic efficacy of each index for sepsis. Results Serum IL-18, IL-18/IL-35 and PCT in group A were significantly higher than those in group B, and IL-35 was significantly lower than that in group B (P<0.01). There was statistical difference on serum levels of IL-18, IL-35, IL-18/IL-35 and PCT among group A1, group A2 and group A3 (P<0.05 or P<0.01). According to the sequence of group A1, group A2 and group A3, serum levels of IL-18, IL-35, IL-18/IL-35 and PCT increased in turn, while IL-35 levels decreased in turn. The serum levels of IL-18, IL-18/IL-35 and PCT in group Ay were significantly higher than those in group Ax, and IL-35 was significantly lower than that in group Ax (P<0.01). There was negative correlation between serum IL-18 and IL-35 levels (r=-0.47, P=0.042), and IL-18/IL-35 was positively correlated with PCT levels (r=0.76, P=0.020). The ROC curve and AUC showed that the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and Youden index of IL-18/IL-35+PCT for diagnosis of sepsis were better than IL-18, IL-35, IL-18/IL-35 and PCT (P<0.05). Conclusion Peripheral blood IL-18/IL-35 combined with PCT has high diagnostic efficiency for sepsis, and the high expression of IL-18/IL-35 and/or PCT may indicate heavier lesion and poor prognosis, and the combined detection of the two indicators may have certain guiding significance for the condition and prognosis of sepsis.
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| About author:: Zhu Zhi-xia, E-mail： 527056837@qq.com |
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| ［1］Markwart R, Condotta SA, Requardt RP, et al. Immunosuppression after sepsis: systemic inflammation and sepsis induce a loss of nave T-cells but no enduring cell-autonomous defects in T-cell function［J］. PLoS One, 2014, 9(12):e115 094.
［2］李慕聪.白细胞介素-18在部分自身免疫性疾病中的作用［J］.微生物学免疫学进展, 2017, 45(6):85-88.
［3］姚人骐,吴瑶,马兵,等.白细胞介素-35在感染性疾病中的作用及意义［J］.中华危重病急救医学, 2017, 29(9):848-852.
［4］周勇,陈大庆,李萌芳,等.脓毒血症患者血清白细胞介素-27和C-反应蛋白及降钙素原水平与病情严重程度的关系研究［J］.中华医院感染学杂志, 2017, 27(24):5546-5548,5553.
［5］Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)［J］. JAMA, 2016, 315(8):762-774.
［6］周文杰,张小亚,张珺,等.APACHEⅡ和SOFA评分联合血清降钙素原对鲍曼不动杆菌血流感染患者预后的预测价值［J］.中国急救医学, 2017, 37(3):221-225.
［7］Desai S, Lakhani JD. Utility of SOFA and APACHE Ⅱ score in sepsis in rural set up MICU［J］. J Assoc Physicians India, 2013, 61(9):608-611.
［8］Desrumaux C, Lemaire-Ewing S, Ogier N, et al. Plasma phospholipid transfer protein (PLTP) modulates adaptive immune functions through alternation of T helper cell polarization［J］. Cell Mol Immunol, 2016, 13(6):795-804.
［9］Wawrocki S, Druszczynska M, Kowalewicz-Kulbat M, et al. Interleukin 18 (IL-18) as a target for immune intervention［J］. Acta Biochim Pol, 2016, 63(1):59-63.
［10］Hiraki S, Ono S, Kinoshita M, et al. Neutralization of IL-10 restores the downregulation of IL-18 receptor on natural killer cells and interferon-γ production in septic mice, thus leading to an improved survival［J］. Shock, 2012, 37(2):177-182.
［11］Wynn JL, Wilson CS, Hawiger J, et al. Targeting IL-17A attenuates neonatal sepsis mortality induced by IL-18［J］. Proc Natl Acad Sci USA, 2016, 113(19):E2627-2635.
［12］张雷,熊建琼,张彦,等.老年脓毒血症患者血清中白细胞介素及外周血淋巴细胞亚群变化的临床意义［J］.中华细胞与干细胞杂志(电子版), 2016, 6(2):105-109.
［13］Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection［J］. Lancet, 1993, 341(8844):515-518.
［14］Wang Y, Yan J. Procalcitonin-guided antibiotic therapy in sepsis［J］.Zhonghua Nei Ke Za Zhi, 2018, 57(6):464-465.
［15］宋笑飞,宋玉成,袁远,等.白细胞介素-35在腹腔感染导致脓毒血症中的诊断价值［J］.中华实验外科杂志, 2017, 34(9):1562-1564.
［16］Siloi I, Pǎdureanu V, et al. Sepsis and identification of reliable biomarkers for postoperative period prognosis［J］.Rom J Morphol Embryol, 2018, 59(1):77-91. |
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