摘要
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.
出处
《中国急救复苏与灾害医学杂志》
2018年第1期33-35,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
重庆市卫生计生委科研项目(2015MSXM160)
重庆市巴南区社会事业科技计划项目(2016-6)