IL-6、肿瘤坏死因子α及CRP对下肢创伤患者合并感染的预测价值分析

Analysis of the predictive value of IL-6,tumor necrosis factor alpha and CRP in patients with lower limb trauma combined with infection

目的分析白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)在下肢创伤合并感染患者中的的表达水平,并研究其临床病情预测价值。方法分析本院2017年10月至2019年10月收治的96例下肢创伤患者与同期在本院96例体检人群临床资料,比较不同人群中IL-6、TNF-α、CRP表达水平,下肢创伤患者不同时间(入院初诊、伤后6 h、3 d、7 d)IL-6、TNF-α、CRP表达水平,并分析下肢创伤患者出现感染的危险因素。结果不同分组间IL-6、TNF-α、CRP表达水平存在明显差异,正常对照组明显低于下肢创伤组,差异有统计学意义(P<0.05);下肢创伤患者在受伤后不同时间中IL-6、TNF-α、CRP表达存在差异,在3 d时患者IL-6、TNF-α、CRP表达水平达到高峰,在7 d时降低,但仍高于初诊(P<0.05);本研究96例下肢创伤患者合并感染31例,感染组IL-6、TNF-α、CRP表达水平明显高于未感染组,差异有统计学意义(P<0.05);通过单因素分析和多因素分析,结果显示IL-6、TNF-α、CRP表达水平为下肢创伤患者出现感染的独立危险因素(P<0.05)。结论动态监测下肢创伤患者外周血中IL-6、TNF-α、CRP水平变化,可为患者病情评估、感染预测提供重要参考依据。

Objective To analyze the expression levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)in patients with trauma of lower limb combined with infection,and to study its predictive value for clinical condition. Methods The clinical data of 96 patients with trauma of lower limb admitted in our hospital from October 2017 to October 2019 and the clinical data of 96 people with medical examination in our hospital at the same time were analyzed retrospectively. The levels of IL-6,TNF-α,and CRP between different groups were compared,the levels of IL-6,TNF-α,and CRP in patients with trauma of lower extremity at different times(preliminary diagnosis on admission,6 h,3 d,and 7 d after injury)were analyzed,and the risk factors of infection of patients with trauma of lower limb were analyzed. Results There were significant differences in the expression levels of IL-6,TNF-α,and CRP among different groups. The normal control group was significantly lower than the lower limb trauma group,and the difference was statistically significant(P<0.05). There are differences in the expression of IL-6,TNF-α,and CRP in patients with lower limb trauma at different times after injury. The expression levels of IL-6,TNF-α,and CRP in the patients reached a peak on the 3 rd day,and decreased on the 7 th day,but still high at the first visit(P<0.05).In this study,96 patients with lower extremity trauma were co-infected. The expression levels of IL-6,TNF-αand CRP in the infected group were significantly higher than those in the uninfected group,and the difference was statistically significant(P<0.05). The univariate analysis and multivariate analysis showed that the expression levels of IL-6,TNF-α,and CRP were independent risk factors for infection in patients with lower limb trauma(P<0.05). Conclusion Dynamic monitoring of the changes of IL-6,TNF-αand CRP levels in the peripheral blood of patients with lower extremity trauma can provide an important reference for the assessment of the patients condition and the prediction of injury and infection.