血清巨噬细胞迁移抑制因子和白细胞介素10水平与重症脓毒症患者生存时间的相关性

Correlation between serum macrophage migration inhibitory factor and interleukin-10 levels and survival time of patients with severe sepsis

目的 探讨血清巨噬细胞迁移抑制因子(MIF)和白细胞介素-10(IL-10)水平对重症脓毒症患者生存时间的影响。方法 收集2015年7月至2017年7月于该院住院接受治疗的重症脓毒症患者入组。记录患者的性别、年龄和器官功能障碍信息。根据患者生存时间将其分为A、B两组,A组生存时间小于72h,B组生存时间大于30d。采用酶联免疫吸附(ELISA)试剂盒测定血清MIF和IL-10水平。采用COX回归分析脓毒症死亡风险的影响因素。结果 A、B两组间性别、年龄、呼吸功能障碍和肾、肝功能损害情况差异无统计学意义(P>0.05);而在心血管功能障碍、乳酸代谢障碍和血液功能障碍3方面差异有统计学意义(P<0.05)。A组血清MIF和IL-10水平分别为(7633±658)和(883±312)pg/mL,B组血清MIF和IL-10水平分别为(2598±764)和(583±276)pg/mL;A组的血清MIF和IL-10水平均高于B组,差异有统计学意义(P<0.05)。单因素和多因素分析均表明心血管、代谢和血液功能障碍以及MIF和IL-10水平升高均为脓毒症死亡风险因素,差异有统计学意义(P<0.05)。结论 心血管、代谢和血液功能障碍以及MIF和IL-10水平升高是重症脓毒症患者快速死亡的风险因素。

Objective To investigate the effects of serum macrophage migration inhibitory factor (MIF) and interleukin-10 (IL-10) levels on the survival time of patients with severe sepsis. Methods The patients with severe sepsis hospitalized in the hospital from July 2015 to July 2017 were collected.The patients′ gender,age,and organ dysfunction information were recorded.According to the survival time of patients,they were divided into A and B groups.The survival time of group A was less than 72 hours,and the survival time of group B was greater than 30 days.Serum MIF and IL-10 levels were measured using an enzyme-linked immunosorbent assay (ELISA) kit.Cox regression was used to analyze the risk factors for sepsis mortality. Results There were no significant differences in gender,age,respiratory dysfunction and renal and hepatic impairment between the two groups ( P >0.05),but there were statistical differences in cardiovascular dysfunction,substance metabolism disorder and blood dysfunction between the two groups ( P <0.05).Serum MIF and IL-10 levels in group A were (7633±658) and (883±312) pg/mL,respectively,and serum MIF and IL-10 levels in group B were (2598±764) and (583±276) pg/mL,and serum MIF and IL-10 levels in group A were significantly higher than those in group B and the differences were statistically significant ( P <0.05).Both univariate and multivariate analysis showed that cardiovascular,metabolic,and hematologic dysfunction,as well as elevated MIF and IL-10 levels were risk factors for death of sepsis patients ( P <0.05). Conclusion Cardiovascular,metabolic,and blood dysfunction,as well as elevated MIF and IL-10 levels,are risk factors for rapid death in patients with severe sepsis.