白细胞介素-6和C反应蛋白联合诊断预测开放性胸部创伤患者预后的临床研究

Clinical study on interleukin-6 combined with C-reactive protein in predicting prognosis of patients with open chest trauma

目的:探究IL-6和CRP水平联合诊断应用于胸部创伤患者预后的预测价值。方法:纳入本院200例胸部创伤患者,检测比较不同创伤程度胸部创伤患者外周血中IL-6、CRP的表达水平,分析IL-6、CRP水平与预后结局的关系,并用ROC曲线来检验IL-6、CRP单独和联合应用对患者预后结局的预测价值。结果:IL-6、CRP水平在所有患者中均呈先升后降的波动性变化,在创伤后3d达到最高值(P<0.05),于创伤后12d降至最低(P<0.05),危重组患者IL-6、CRP水平的变化明显高于轻度组及重度组(P<0.05);死亡组患者IL-6、CRP表达水平明显高于生存组患者(P<0.05);IL-6、CRP和联合诊断的ROC曲线AUC面积均大于0.6,且联合诊断的AUC面积明显大于二者单独预测(P<0.05)。结论:IL-6、CRP水平与胸部创伤患者预后的关系紧密,其升高水平与创伤严重程度相关,可用于预后评估,而联合诊断的预测效果更佳。

Objective:To explore the predictive value of IL-6 combined with CRP on prognosis of patients with open chest trauma.Methods:A total of 200 patients with chest trauma in this hospital were included.The expression levels of IL-6 and CRP in peripheral blood were detected and compared among patients with chest trauma of different degrees,and the relationship between levels of IL-6 and CRP and prognosis outcome was analyzed.The predictive value of single or combined application of IL-6 and CRP on prognosis outcome of patients was tested by ROC curve.Results:The levels of IL-6 and CRP were increased first and then decreased among all patients,and reached the highest values at 3d after trauma(P<0.05),and reached the lowest values at 12d after trauma(P<0.05).The changes of levels of IL-6 and CRP in extremely severe group were significantly higher than those in mild group and severe group(P<0.05).The expression levels of IL-6 and CRP in death group were significantly higher than those in survival group(P<0.05).The AUC values of ROC curves of IL-6,CRP and combined diagnosis were all greater than 0.6,and the AUC value of combined diagnosis was significantly larger than that of single diagnosis of the two(P<0.05).Conclusion:The levels of IL-6 and CRP are closely related to the prognosis of patients with chest trauma,and their elevated levels are correlated with the severity of trauma,and they can be used for prognosis assessment.What’more,combined diagnosis is more effective in predicting the prognosis.