IL-6、CRP、PCT和内毒素预判肝衰竭合并细菌感染风险中的临床价值

Clinical value of IL-6,CRP,PCT and endotoxin in predicting the risk of liver failure with bacterial infection

目的探讨白细胞介素-6(Interleukin-6,IL-6)、C-反应蛋白(C-reactive protein,CRP)、降钙素原(Procalcitonin,PCT)和内毒素(Lipopolysaccharide,LPS)在预判肝衰竭合并细菌感染风险中的临床价值。方法选取2018年1月-2019年11月就诊于赣州市第五人民医院的肝衰竭患者100例为研究对象,根据有无合并细菌感染分为研究组和对照组,各50例。采用双抗夹心酶联免疫吸附试验对血清IL-6水平进行检测,采用自动生化分析仪对CRP和PCT水平进行检测;采用鲎试剂动态比浊试验对血清LPS水平进行检测;分析患者的性别、年龄、肝功能Child-Pugh分级、基础疾病、肝衰竭类型、IL-6水平、CRP水平、PCT水平、LPS,归纳肝衰竭患者合并细菌感染的影响因素。结果研究组患者的血清IL-6、CRP、PCT、LPS分别为(3.38±0.91)mg/ml、(49.35±7.04)ng/ml、(1.10±0.09)ng/ml、(11.69±2.85)pg/ml高于对照组(P<0.05);肝功能Child-Pugh分级、IL-6、CRP、PCT、LPS是肝衰竭患者合并细菌感染的影响因素(P<0.05)。结论肝衰竭合并细菌感染患者血清IL-6、CRP、PCT、LPS水平升高,在预判肝衰竭合并细菌感染风险中有一定的临床价值。

OBJECTIVE To explore the clinical value of interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT)and lipopolysaccharide(LPS)in predicting the risk of liver failure with bacterial infection.METHODS A total of 100patients with liver failure who were admitted to the Fifth People′s Hospital of Ganzhou City from Jan.2018to Nov.2019were selected as the research subjects,and were divided into a study group and a control group according to the presence or absence of combined bacterial infection,with 50cases each.The levels of serum IL-6were detected by double anti-sandwich enzyme-linked immunosorbent assay,CRP and PCT were detected by automatic biochemical analyzer,serum LPS level were detected by limulus amebocyte lysate dynamic Turbidimetry test.The patient’s gender,age,child-Pugh classification of liver function,underlying disease,liver failure type,IL-6level,CRP level,PCT level and LPS were analyzed,and the influencing factors of liver failure patients with bacterial infection were summarized.RESULTS The serum IL-6,CRP,PCT and LPS in the study group were(3.38±0.91)mg/ml,(49.35±7.04)ng/ml,(1.10±0.09)ng/ml,and(11.69±2.85)pg/ml,respectively,significently higher than those in the control group(P<0.05).Child-Pugh classification of liver function,IL-6,CRP,PCT,and LPS were the influencing factors of liver failure patients with bacterial infection(P<0.05).CONCLUSIONThe serum levels of IL-6,CRP,PCT and LPS in patients with liver failure complicated with bacterial infection were significantly increased,which has certain clinical value in predicting the risk of liver failure comlicated with bacterial infection.