细胞因子谱检测在重症感染早期诊断及指导治疗中的临床应用

Clinical application of cytokine profiling in early diagnosis and guiding treatment of severe infection

目的:探讨细胞因子谱检测在重症感染早期诊断及指导治疗中的临床应用价值。方法:采取回顾性研究模型,选取2018年1月~2019年6月徐州矿务集团总医院收治重症感染患者50例为重症感染组,同期本院健康体检者50例为对照组。对比两组细胞因子(IL-6、IL-10、IL-17A,IFN-γ)、C反应蛋白(CRP)、降钙素原(PCT)等相关炎性指标水平并采用受试者工作特征(ROC)曲线评价上述指标在重症感染患者的诊断效能。结果:重症感染组IL-6、IL-10、IL-17A.CRP及PCT水平明显高于对照组,差异有统计学意义(P<0.01);两组间IFN-γ水平比较差异均无统计学意义(P>0.05).ROC曲线分析显示,IL-6诊断重症感染的敏感度为82.0%,特异度为78.4%;IL-10诊断重症感染的敏感度为68.0%,特异度为88.0%,两者的敏感度和特异度均高于IL-17A和IFN-γ,但低于CRP和PCT。结论:IL-6、IL-10等细胞因子检测以其较好特异性及较高的诊断效能在重症感染患者早期诊疗中具有较好的临床应用价值,为临床医生早期治疗提供重要的实验室依据。

Objective: To investigate the clinical application value of cytokine profiling in the early diagnosis and treatment of severe infection. Methods: A retrospective study model was adopted. From January 2018 to June 2019, 50 patients with severe infections in the Xuzhou Mining Group General Hospital were selected as the severe infection group. In the same period, 50 healthy subjects in the hospital were the control group. Comparison of cytokines (IL- 6,IL-10,IL-17A,IFN-γ), C-reactive protein (CRP), procalcitonin (PCT) and other related inflammatory markers and using receiver operating characteristics (ROC) curve evaluates the diagnostic efficacy of the above indicators in patients with severe infection. Results:The levels of IL-6,IL-10,IL-17A, CRP and PCT in the severely infected group were significantly higher than those in the control group (P < 0.01). There was no significant difference in IFN-γ levels between the two groups. Significance (P > 0.05). ROC curve analysis showed that the sensitivity of IL-6 in the diagnosis of severe infection was 82.0%, the specificity was 78.4%;the sensitivity of IL-10 in the diagnosis of severe infection was 68.0%, the specificity was 88.0%, the sensitivity and specificity of the two The degree is higher than IL-17A and IFN-γ, but lower than CRP and PCT. Conclusion: The detection of cytokines such as IL-6 and IL-10 has good clinical application value in early diagnosis and treatment of severely infected patients with its good specificity and high diagnostic efficiency, which provides an important laboratory basis for early treatment of clinicians.