ICU谵妄患者血清炎症因子水平的变化

Serum inflammatory factor in patients with delirium in intensive care unit

目的比较ICU谵妄患者与非谵妄患者炎症因子水平的差异。方法选择ICU停留时间>24 h的34例患者,采用重症监护病房患者意识模糊评估法(CAM-ICU)诊断谵妄,将患者分为谵妄组(17例)和非谵妄组(17例)。使用流式细胞蛋白分析技术(CBA)测定34例患者血浆中六类炎症因子水平--白细胞介素(interleukin,IL)-8、IL-6、IL-1β、IL-10、IL-12p70、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)。结果 IL-8、IL-6、IL-1β、IL-10、TNF-α在两组患者中结果比较差异均无统计学意义(P>0.05),IL-12p70水平在谵妄组明显高于非谵妄组(P<0.05)。IL-12p70预测ICU谵妄发生的受试者工作特征(ROC)曲线下面积(AUC)为0.728,以11.1 pg/mL为阈值,预测的敏感度为70.6%,特异度为76.5%。结论 ICU患者发生谵妄可能与炎症因子IL-12p70释放增加有关,早期检测IL-12P70水平可能有助于预测其风险。

Objective To compare the levels of inflammatory factors between patients with delirium and non-delirium in intensive care unit(ICU). Methods A total of 34 patients, who stayed in ICU more than 24 hours, were enrolled from February 2017 to February 2018. Patients were divided into delirium group(17 cases) and non-delirium group(17 cases). Delirium was assessed twice daily with the confusion assessment method-intensive care unit(CAM-ICU). The concentrations of inflammatory factors, including IL-8, IL-6, IL-1β, IL-10, TNF-α, IL-12 p70, were determined with cytometric bead array. Results There was no significant difference in IL-8, IL-6, IL-1β, IL-10 and TNF-α between the two groups(P>0.05). IL-12 p70 of delirium patients was significantly higher than the non-delirium patients(P<0.05). The area under ROC curve(AUC) for IL-12 p70 predicting delirium was 0.728, while the sensitivity and specificity of IL-12 p70 at threshold of 11.1 were 70.6% and 76.5%, respectively. Conclusion IL-12 p70 in ICU delirium patients is significantly increased. Early detection of IL-12 p70 can help to predict the risk of delirium for critically ill patients.