全身炎性反应综合征患者血清C反应蛋白、白细胞介素6和D-二聚体的变化

Changes of serum C-reaction protein,interleukin-6 and D-Di in patients with neurology critically ill combined with systemic inflammatory response syndrome

目的探讨神经科并发全身炎性反应综合征(SIRS)的危重症患者血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)和D-二聚体(D-Di)水平变化及其与多器官功能障碍综合征(MODS)和病死率的关系。方法将120例神经科危重症患者根据是否并发SIRS分为SIRS组(48例)和非SIRS组(72例),分别于发病24 h内及3 d、7 d晨起空腹抽取静脉血5 mL,测定血清CRP、IL-6、D-Di水平,并观察两组患者的MODS发生率和病死率。结果发病24 h内、3 d、7 d不同时间血清CRP,非SIRS组内比较差异无统计学意义(P>0.05),但SIRS组内比较差异有统计学意义(P<0.05);各时间点SIRS组血清CRP水平明显高于非SIRS组(P<0.01)。SIRS组发病24 h内、3 d、7 d时血清IL-6明显高于非SIRS组(P<0.05)。非SIRS组发病24 h内、3 d、7 d不同时间D-Di水平比较差异无统计学意义(P>0.05),SIRS组内比较差异有统计学意义(P<0.05);各时间点SIRS组D-Di水平明显高于非SIRS组(P<0.01)。SIRS组MODS发生率明显高于非SIRS组(χ2=5.042,P<0.05),SIRS组病死率明显高于非SIRS组(χ2=7.879,P<0.05)。结论血清CRP、IL-6及D-Di可作为预测MODS的早期指标。

Objective To observe the changes of serum C-reaction protein （CRP）,interleukin-6 （IL-6 ） and D-Di （D-Di）in patients with neurology critically ill combined with systemic inflammatory response syndrome （SIRS）,and study the relationship to multiorgan dysfunction syndrome （MODS）and fatality rates.Methods In a prospectie case-control study,120 patients with neurology critically ill were divided into SIRS （48 cases）and non SIRS （72 cases）group.5 mL venous blood were took during the fasting at morbidity 24h,3d and 7d to determine serum CRP,IL-6,D-Di,and incidence rates of MODS and fatality rates were observed in two groups.Results There was no significant difference in serum CRP at morbidity 24h,3d and 7d in non SIRS group （P〉0.05 ）,but there was significant difference in SIRS group（P〈0.05）.The serum CRP in SIRS group was higher obviously than that in non SIRS group at different time（P〈0.01）.The serum IL-6 in SIRS group was higher obviously than that in non SIRS group at different time（P〈0.01）.There was no significant difference in serum D-Di at morbidity 24h,3d and 7d in non SIRS group （P〉0.05）,but there was significant difference in SIRS group（P〈0.05）.The serum D-Di in SIRS group was higher obviously than that in non SIRS group at different time （P〈0.01 ）.The incidence rate of MODS was higher obviously in SIRS group than that in non SIRS group（χ^2 =5.042,P〈0.05）.The fatality rate was higher obviously in SIRS group than that in non SIRS group（χ^2 =7.879,P〈0.05）.Conclusion Serum CRP,IL-6 and D-Di can be regarded as indexes of predicting MODS.