脓毒症患者中心静脉-动脉血二氧化碳分压差与IL-6、IL-10及降钙素原的关系

Correlation of central venous-to-arterail carbon dioxide difference with interleukin-6, IL-IO, and procalcitonin in patients with sepsis

目的 探讨脓毒症患者中心静脉-动脉血二氧化碳分压差[P（cv-a）CO2]与血清白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、降钙素原水平的关系.方法 收集2015年1月-2016年7月重庆市巴南区人民医院重症医学科收住的82例脓毒症患者的临床资料,测定患者入住重症医学科后2 h内中心静脉-动脉血二氧化碳分压差[P （cv-a）CO2].同时测定血清IL-6、IL-10及PCT水平.根据中心静脉-动脉血二氧化碳分压差[P（cv-a）CO2]将患者分为正常P（cv-a）CO2组（P（cv-a）CO2≤6mmHg）,共49例;高P（cv-a）CO2组（P（cv-a）CO2〉6mmHg）,共33例.分析P（cv-a）CO2与血清IL-6、IL-10及PCT的关系.结果 与正常P（cv-a）CO2组比较,高P（cv-a）CO2组患者IL-6、IL-10及PCT含量明显升高[IL-6（pg/ml）：48.27±17.28比16.87±5.49、IL-10（pg/ml）：203.76±57.28比59.87±21.45、PCT （ng/ml）：2.57±0.95比5.24±1.26].差异均有统计学意义（P〈0.05）.相关性分析表明脓毒症患者Pcv-aCO2与血清IL-6、IL-10呈正相关（rIL-6=0.57;rIL-10=0.84,均P〈0.05）,与血清PCT无相关性（rPCT=-0.079,P〉0.05）.结论 脓毒症患者P（cv-a）CO2与血清IL-6、IL-10呈正相关性.因此推测P（cv-a）CO2可能通过炎症反应介导而对机体产生损伤作用.

Objective To investigate the correlation of central venous-to-arterail carbon dioxide difference [P（cv-a） CO2]with the serum levels of interleukin（IL）-6,IL-10,and procalcitonin（PCT）in the patients with sepsis.Methods Blood samples of femoral artery and central vein were collected from 82 patients with sepsis within 2 hours after arrival at the hospital to measure the Pcv-aCO2and serum levels of IL-6,IL-10,and PCT.Those with the P（cv-a）CO2〈6 mmHg（n=49）were regarded as the nomal P（cv-a）CO2group,and the 33 patients with the P（cv-a）CO2≥6 mmHg were regarded as the high P（cv-a）CO2group.Pearson correlation analysis was used to study the correlation of the P（cv-a） CO2with the serum levels of interleukin（IL）-6,IL-10,and procalcitonin（PCT）. Results The serum levels of IL-6, IL-10, and PCT of the high P（cv-a）CO2group were （48.27 ± 17.28） pg/ml, （203.76 ± 57.28） pg/ml, and （1715.14 ± 167.12） ng/ml respectively, all significantly higher than those of the normal P（cv-a）CO2group [（16.87±5.49） pg/ml, （59.87 ± 21.45} pg/ml, and （1229.71 ± 154.49） ng/ml respectively, all P〈0.05]. Correlation analysis showed that Pcv-aCO2was positively correlated with serum IL-6 and IL-10 level（rIL-6=0.57,rIL-10=0.84,both P〈0.021）,and not significantly correlated with the serm PCT（rPCT=-0.079, P〉0.05）. Conclusion Pcv-aCO2is positively correlated with IL-6 and IL-10 levels in the sepsis patients,indicating that P（cv-a）CO2damage effect may be mediated through inflammatory reaction.