| 杨劲木,解 迪,代 会,王晓婉,费爱华.白细胞介素-39联合降钙素原评估脓毒症严重程度的临床价值[J].,2021,(24):4654-4659 |
| 白细胞介素-39联合降钙素原评估脓毒症严重程度的临床价值 |
| Clinical Value of Interleukin-39 Combined with Procalcitonin in Assessing the Severity of Sepsis |
| 投稿时间：2021-03-28 修订日期：2021-04-24 |
| DOI：10.13241/j.cnki.pmb.2021.24.011 |
| 中文关键词: 脓毒症 白细胞介素-39 降钙素原 |
| 英文关键词: Sepsis Interleukin-39 Procalcitonin |
| 基金项目:上海市科学技术委员会基金项目（17dz2307600） |
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| 中文摘要: |
| 摘要 目的：探讨白细胞介素-39（Interleukin-39, IL-39）联合降钙素原 （Procalcitonin, PCT）对脓毒症严重程度的评估价值。方法：随机选取2019年12月至2020年12月上海交通大学医学院附属新华医院及瑞金医院因感染入院患者100例，分为非脓毒症组、脓毒症组和脓毒症休克组，根据28天内脓毒症患者是否死亡，分为死亡组和存活组，另纳入40例健康人为对照组。测量患者入院24小时内的IL-39及PCT水平，绘制受试者工作特征曲线（Receiver operating characteristic curve, ROC）分析IL-39、PCT 及二者联合对脓毒症患者病情严重程度的评估价值。结果：所有感染组IL-39、PCT水平均高于健康对照组，且随着病情严重程度的增加而升高，从低到高的顺序为健康对照组<非脓毒症组<脓毒症组<脓毒症休克组，死亡组患者IL-39、PCT水平高于存活组；ROC曲线分析IL-39和PCT以及二者联合对预测脓毒症休克的曲线下面积（Area under curve, AUC）为0.776，0.794，0.866，灵敏度为81.0 %，61.9 %，90.5 %，特异度为74.4 %，84.6 %，66.7 %，约登（Youden）指数分别为0.5531，0.4652，0.5714，截断值分别为115.05 pg/mL，33.18 ng/mL；ROC曲线分析IL-39和PCT以及二者联合预测患者死亡的价值，AUC为0.798，0.774，0.868，灵敏度为90.9 %，54.6 %，90.9 %，特异度为65.3 %，87.8 %，79.6 %，Youden指数分别为0.5622，0.4230，0.7050，截断值分别为115.05 pg/mL，46.59 ng/mL。结论：IL-39联合PCT评估脓毒症严重程度的临床价值，优于PCT单项预测，检测IL-39水平有助于脓毒症病情的早期评判。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the value of IL-39 combined with PCT in the assessment of severity of sepsis. Methods: A total of 100 patients with infection were randomly selected from Xinhua Hospital and Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2019 to December 2020. They were divided into non-sepsis group, sepsis group and septic shock group. According to whether sepsis patients died within 28 days, they were divided into death group and survival group, and forty healthy subjects were included as control group. IL-39 and PCT levels were measured within 24 hours of admission. Receiver operating characteristic curve (ROC) was used to analyze the evaluation value of IL-39, PCT and their combination on the severity of sepsis patients. Results: The levels of IL-39 and PCT in all infection groups were higher than those in the healthy control group, and elevated with the severity of the disease. The levels of IL-39 and PCT in each group from low to high were healthy control group, non-sepsis group, sepsis group, and the septic shock group. For the analysis of IL-39, PCT and their combination to predict septic shock, the area under curve (AUC) were 0.776, 0.794, and 0.866, the sensitivity were 81.0 %, 61.9 %, and 90.5 %, the specificity were 74.4 %, 84.6 %, and 66.7 %, Youden index were 0.5531, 0.4652, and 0.5714, respectively, and the cut-off value were 115.05 pg/mL and 33.18 ng/mL. As for the prediction of patient death, the AUC were 0.798, 0.774, and 0.868, the sensitivity were 90.9 %, 54.6 %, and 90.9 %, the specificity were 65.3 %, 87.8 %, and 79.6 %, and the Youden index were 0.5622, 0.4230, and 0.7050, and the cut-off value were 115.05 pg/mL and 46.59 ng/mL. Conclusion: The clinical value of IL-39 combined with PCT in assessing the severity of sepsis was superior to PCT alone. The level of IL-39 was helpful for early assessment of sepsis. |
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