脓毒症患者血清IL-6及IL-10浓度变化与预后的相关性研究

Correlated study on the changes of IL-6 and IL-10 levels with the prognosis of patients with sepsis

目的:探讨脓毒症患者血清IL-6和IL-10浓度变化与脓毒症预后的相关性。方法:本研究纳入52例脓毒症患者,其中存活37例,死亡15例。于入组第1天及第5天抽取静脉血标本,采用双抗体夹心酶联免疫吸附法(ELISA)测定血清IL-6和IL-10浓度;同时采用急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)进行评分,研究血清IL-6及IL-10浓度与APACHEⅡ的相关性。结果:入组第5天死亡组IL-6水平较第1天上升(P=0.043),存活组IL-6较第1天下降(P=0.018),两组间第5天IL-6浓度比较差异有统计学意义(P<0.001)。入组第5天两组IL-10均较第1天下降,存活组下降更为明显(P<0.001)。入组第5天死亡组APACHEⅡ评分较第1天上升,存活组较第1天下降,两组有统计学意义(P=0.001)。入组第1天和第5天两组的IL-6浓度均与当日APACHEⅡ评分有显著相关性(P<0.05),第5天仅IL-10浓度与APACHEⅡ评分有显著相关性(P<0.05)。结论:脓毒症患者血清IL-6水平与APACHEⅡ评分显著相关,不同时间点IL-10水平与预后的相关性尚不确定,动态监测其变化趋势有助于脓毒症预后的判断。

Objective： To explore the correlation between serum interleukin- 6 （ IL- 6 ）, interleukin- 10 （ IL- 10 ） levels and prognosis of sepsis. Methods： A total of 52 patients with sepsis were enrolled in the study, of which 37 patients survived and 15 patients died. The serum IL-6 and IL-10 levels were detected by ELISA method on the 1st and 5th day, and meanwhile the acute physiology and chronic health evaluation I1 （ APACHE Ⅱ ） scores were evaluated to study their correlation. Results： The serum IL-6 level on the 5th day was significantly higher than that on the I st day in the dead group （ P = 0.043 ）, but which declined significantly in the survived group （ P = 0.018 ）. The difference was statistically significant between the two groups on the 5th day（P 〈 0.001 ）. The serum IL-10 levels on the 5th day was lower than that on the 1st day both in the survived group and the dead group, but statistical difference was only found in the survived group. The APACHE 11 score on the 5th day was higher than that on the 1 st day in the dead group, but which declined significantly in the survived group. The difference was statistically significant between the two groups on the 5th day（P = 0. 001 ）. The serum IL-6 levels were obviously correlated with the APACHEⅡ scores on the 1st day and 5th day（ P 〈0.05 ）, but the IL-10 level only on the 5th day was correlated significantly with the APACHE Ⅱ score （P 〈 0.05 ）. Conclusion： The serum IL-6 level is obviously correlated with the APACHE Ⅱ score in patients with sepsis. No definite relationship is found between the IL-10 level and prognosis on different time, so dynamic monitoring of the serum IL-10 levels is valuable for prognosis assessment.