SOFA评分联合IL-6检测对复杂腹腔感染患者预后评估价值

Prognostic value of SOFA score combined with IL-6 detection in patients with complicated intra-abdominal infections

目的探讨脓毒症相关器官功能障碍评分(sepsis-related organ failure assessment score,SOFA评分)联合白细胞介素-6(Interleukin-6,IL-6)检测在复杂腹腔感染患者预后中的评估价值。方法选取2014年1月-2017年11月于医院ICU进行治疗的复杂腹腔感染患者82例为研究对象,依据预后结果将纳入患者分为存活组(n=60)和死亡组(n=22)。统计两组患者临床资料;采用酶联免疫吸附法测定并对比患者IL-6等炎症指标水平变化;统计分析两组患者SOFA评分;分析SOFA评分与IL-6相关性;绘制并比对患者SOFA评分、IL-6及二者联合检测的诊断效能。结果存活组SOFA评分和IL-6水平均低于死亡组(P<0.05);两组患者IL-6水平越高,则SOFA评分越高;SOFA评分诊断的灵敏度为79.55%,特异度为77.48%,ROC曲线下面积为0.804;IL-6诊断的灵敏度为71.02%,特异度为72.27%,ROC曲线下面积为0.712;二者联合诊断的灵敏度为87.22%,特异度为85.96%,ROC曲线下面积为0.918;SOFA评分与IL-6二者联合检测的ROC曲线下面积、灵敏度以及特异度均高于单项指标检测(P<0.05)。结论 SOFA评分与IL-6联合检测在复杂腹腔感染患者预后中具有较高的灵敏度和准确度,对临床制定其预后方案具有一定的指导作用。

OBJECTIVE To investigate the prognostic value of SOFA score combined with IL-6 detection in patients with complicated intra-abdominal infections. METHODS A total of 82 patients with complicated abdominal infections who were treated in the ICU of our hospital from Jan. 2014 to Nov. 2017 were enrolled, and divided irito the survival group (n=60 cases) and the death group (n = 22 cases) according to the prognosis. The clinical data of the two groups of patients were statistically analyzed. Enzyme-linked immunosorbent assay (ELISA) was used to determine and compare the changes of IL-6 levels. The SOFA scores of the two groups were calculated and compared. The correlation between the SOFA score and the IL-6 level was analyzed, and the diagnostic efficacy of SOFA scores, IL-6 and combined test of both were drawn and compared. RESULTS The average SOFA scores and IL-6 level in the survival group were significantly lower than those in the death group (P<0.05). The higher the level of IL-6 in the two groups, the higher the SOFA score. The sensitivity of diagnosis using the SOFA score was 79.55%, the specificity was 77.48%, and the area under the ROC curve was 0.804. The sensitivity of diagnosis using IL-6 was 71.02%, the specificity was 72.27%, and the area under the ROC curve was 0.712. The sensitivity of diagnosis using the combined test was 87.22 %, the specificity was 85.96%, and the area under the ROC curve was 0.918. The area under the ROC curve, sensitivity and specificity measured by the combined diagnosis using SOFA scores and the IL-6 level were significantly higher than those of diagnosis using single indexes (P<0.05). CONCLUSION The combined detection of SOFA score and IL-6 has a high sensitivity and accuracy in the prognosis of patients with complex abdominal infection , which has a certain guiding role in the clinical formulation of its prognosis program.