IL-6、TNF-α及血磷在老年脓毒症患者中的变化和相关性

Changes and Correlations of IL-6,TNF-αand Blood Phosphorus in Elderly Patients with Sepsis

目的探讨IL-6、TNF-α和血磷在老年脓毒症患者中的变化和相关性。方法回顾性分析2017年1月~2019年3月我院治疗的70例老年脓毒症患者的临床资料,根据临床转归情况分为存活组(48例)和死亡组(22例),比较两组临床资料、入住ICU第1、3、5、7天血磷、IL-6、TNF-α水平。结果两组性别、年龄、感染部位比较,差异无统计学意义(P>0.05)。两组入住ICU第1、3天血磷水平比较,差异无统计学意义(P>0.05);存活组入住ICU第5、7天血磷水平高于死亡组,差异有统计学意义(P<0.05);两组入住ICU第1天IL-6水平比较,差异无统计学意义(P>0.05);死亡组入住ICU第3、5、7天IL-6水平高于存活组,差异有统计学意义(P<0.05);两组入住ICU第1、3天TNF-α水平比较,差异无统计学意义(P>0.05);死亡组入住ICU第5、7天TNF-α水平高于存活组,差异有统计学意义(P<0.05)。相关性分析显示,入住ICU第1天,血磷与TNF-α呈正相关(P<0.05),与IL-6无相关性(P>0.05);入住ICU第3天,血磷与TNF-α、IL-6均无相关性(P>0.05);入住ICU第5、7天,血磷与TNF-α、IL-6均呈负相关(P<0.05)。结论TNF-α及IL-6水平不仅可反映老年脓毒症患者机体炎症反应状况,也可以作为判断疾病预后的相关指标,对临床治疗有一定参考价值,并与血磷呈一定相关性,动态监测血磷能可及时了解老年脓毒症患者的病情变化及预后。

Objective To investigate the changes and correlation of IL-6,TNF-αand blood phosphorus in elderly patients with sepsis.Methods The clinical data of 70 elderly patients with sepsis treated in our hospital from January 2017 to March 2019 were retrospectively analyzed.They were divided into survival group(48 cases)and death group(22 cases)according to clinical outcomes,and collected and compared.Clinical data,blood phosphorus,IL-6,TNF-αlevels on the 1st,3rd,5th,and 7th days after ICU admission.Results There was no significant difference in gender,age,and infection site between the two groups(P>0.05).There was no significant difference in blood phosphorus levels between the two groups on the 1st and 3rd days after admission to the ICU(P>0.05);the blood phosphorus levels on the 5th and 7th days after the ICU stayed in the surviving group were higher than those in the death group,the difference was statistically significant(P<0.05);There was no significant difference in IL-6 levels between the two groups after admission to ICU on the 1st day(P>0.05);IL-6 levels in the death group were higher than those in the survival group on the 3rd,5th,and 7th days after admission to the ICU,the differences were statistically significant(P<0.05);There was no significant difference in TNF-αlevels between the two groups on the 1st and 3rd days after ICU admission(P>0.05);the TNF-αlevels on the 5th and 7th days after ICU admission in the death group were higher than those in the survival group,the difference was statistically significant(P<0.05).Correlation analysis showed that there was a positive correlation between blood phosphorus and TNF-αon the first day of ICU admission(P<0.05)and no correlation with IL-6(P>0.05).There was no correlation between blood phosphorus and TNF-α,IL-6 on the 3rd day after ICU admission(P>0.05);there was a negative correlation between blood phosphorus and TNF-α,IL-6 on the 5th and 7th day after ICU admission(P<0.05).Conclusion The levels of TNF-αand IL-6 can not only reflect the body's inflammatory response status in elderly patients with sepsis,but also can be used as a relevant indicator to judge the prognosis of the disease.Monitoring blood phosphorus can timely understand the changes and prognosis of elderly patients with sepsis.