IL⁃33/ST2信号通路相关因子对颅脑外伤合并SIRS的诊断价值

The diagnostic value of IL⁃33/ST2 signal pathway related factors in craniocerebral trau⁃ma with SIRS

目的探究白细胞介素⁃33(IL⁃33)/特异性受体肿瘤发生抑制蛋白2(ST2)信号通路相关因子对颅脑外伤合并全身炎症反应综合征(SIRS)的诊断价值。方法选取本院2019年7月至2020年12月颅脑外伤合并疑似SIRS患者80例,根据临床确诊结果将SIRS患者46例作为观察组,非SIRS患者34例作为对照组。比较两组临床资料、炎症指标[C反应蛋白(CRP)、降钙素原(PCT)]水平、血清IL⁃33、可溶性ST2(sST2)水平,分析血清IL⁃33、sST2与CRP、PCT、APACHEⅡ评分相关性及颅脑外伤合并SIRS的影响因素,评价血清IL⁃33、sST2单独及联合诊断颅脑外伤合并SIRS的价值。结果两组年龄、颅脑外伤程度、APACHEⅡ评分、CRP、PCT水平比较,差异有统计学意义(P<0.05);观察组血清IL⁃33、sST2水平高于对照组,差异有统计学意义(P<0.05);血清IL⁃33、sST2与CRP、PCT、APACHEⅡ评分呈正相关(P<0.05);Logistic回归分析,年龄、颅脑外伤程度、血清IL⁃33、sST2是颅脑外伤合并SIRS的重要影响因素(P<0.05);ROC曲线分析,血清IL⁃33、sST2联合诊断颅脑外伤合并SIRS的AUC为0.908,95%CI:0.823~0.861,敏感度为78.26%,特异度为91.18%,诊断价值明显优于两者单独诊断(P<0.05)。结论IL⁃33/ST2信号通路相关因子与颅脑外伤病情、炎症反应联系紧密,过度升高表达可作为诊断并发SIRS的潜在思路。

Objective To explore the diagnostic value of interleukin⁃33(IL⁃33)/suppression of tu⁃morigenicity 2(ST2)signaling pathway related factors for traumatic brain injury with systemic inflammatory response syndrome(SIRS).Methods 80 patients with craniocerebral trauma combined with suspected SIRS in our hospital from July 2019 to December 2020 were selected.Based on the clinical diagnosis results,46 SIRS patients were selected as the observation group,and 34 non⁃SIRS patients were used as the control group.The clinical data,inflammatory indicators[C⁃reactive protein(CRP),procalcitonin(PCT)]levels,serum IL⁃33,and soluble ST2(sST2)levels were compared between the two groups.The correlation between serum IL⁃33,sST2 and CRP,PCT,APACHEⅡscores and the influencing factors of SIRS in craniocerebral trauma were analyzed,and the value of serum IL⁃33 and sST2 in diagnosing craniocerebral trauma and SIRS alone or in combination was evaluated.Results There were statistically significant differences in age,degree of traumatic brain injury,APACHEⅡscore,CRP and PCT levels between the two groups(P<0.05).Serum IL⁃33 and sST2 levels in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The serum IL⁃33 and sST2 were positively correlated with CRP,PCT and APACHEⅡscores(P<0.05).Logistic regression analysis showed that age,degree of traumatic brain inju⁃ry,serum IL⁃33 and sST2 were important influencing factors of SIRS with traumatic brain injury(P<0.05).The ROC curve analysis showed that the AUC of the combined diagnosis of serum IL⁃33 and sST2 with SIRS was 0.908,95%CI was 0.823⁃0.861,the sensitivity was 78.26%,and the specificity was 91.18%.The diag⁃nostic value was significantly better than that of the two alone(P<0.05).Conclusion The IL⁃33/ST2 signal⁃ing pathway related factors are closely related to the condition of craniocerebral injury and inflammatory re⁃sponse.Over⁃expression can be used as a potential idea for the diagnosis of SIRS.