补体C3和白细胞介素35(IL-35)在脓毒症病情判断及预后评估中的价值研究

Complement C3and interleukin 35(IL-35)in sepsis study on the value of disease judgment and prognosis evaluation

目的探讨补体C3和白细胞介素35(Interleukin 35,IL-35)在脓毒症病情判断及预后评估中的价值。方法回顾性分析2015年9月-2020年9月期间汉中市中心医院ICU收治的重症患者的临床资料,其中脓毒症患者103例,非脓毒症患者数120例。采集入选患者血液,经离心、静置后,取上层血清,应用酶联免疫吸附法测定血清中相关指标(包括IL-6、IL-35、PCT)水平,应用免疫透射比浊法测定血清中补体C3水平。比较对照组与观察组血清IL-35、PCT、IL-6、补体C3以及APACHEⅡ评分;比较不同发病程度血清IL-35、PCT、IL-6、补体C3以及APACHEⅡ评分;分析影响脓毒症患者预后状况的相关因素;对脓毒症患者血清IL-35及补体C3与APACHEⅡ评分之间的相关性进行分析。结果 (1)除血清补体C3外,观察组其他指标(包括IL-35、IL-6、PCT及APACHEⅡ评分)水平均显著高于对照组(P均<0.05);(2)重度脓毒症患者血清IL-35、PCT、IL-6以及APACHEⅡ评分均分别显著高于轻度患者(P均<0.05),但重度脓毒症患者血清补体C3显著小于轻度患者(P<0.05);(3)死亡组患者血清IL-35、PCT、IL-6以及APACHEⅡ评分均分别显著高于生存组患者(P均<0.05),但死亡组患者血清补体C3显著小于生存组患者(P<0.05);(4)经分析,血清IL-35及补体C3为脓毒症患者预后状况的影响因素。结论 C3与IL-35可作为脓毒症病情判断以及预后状况评估指标,但是相关机制尚需进一步进行探讨。

Objective To investigate the value of complement C3 and Interleukin 35(IL-35)in the diagnosis and prognosis of sepsis.Methods The clinical data of severe patients admitted to ICU of Hanzhong Central Hospital hospital from September 2015 to September 2020 were retrospectively analyzed,including 103 patients with sepsis and 120 patients without sepsis.Blood was collected from the selected patients.After centrifugation and static treatment,the upper serum was taken,and the levels of relevant indexes(including IL-6,IL-35 and PCT)in serum were determined and analyzed by enzym-linked immunosorbent assay.The level of complement C3 in serum was determined and analyzed by immunotransmission turbidimetry.The serum IL-35,PCT,IL-6,complement C3 and APACHEⅡscores were compared between the control group and the observation group.Serum IL-35,PCT,IL-6,complement C3 and APACHEⅡscores were compared in different degrees of disease.To analyze the related factors affecting the prognosis of patients with sepsis.The correlation between serum IL-35 and complement C3 and APACHEⅡ score in sepsis patients was analyzed.Results (1)Except for serum complement C3,the levels of other indexes(including IL-35,IL-6,PCT and APACHEⅡscore)in observation group were significantly higher than those in control group(all P<0.05).(2)Serum IL-35,PCT,IL-6 and APACHEⅡ scores in severe sepsis patients were significantly higher than those in mild sepsis patients(all P<0.05),but serum complement C3 in severe sepsis patients was significantly lower than that in mild sepsis patients(P<0.05).(3)Serum IL-35,PCT,IL-6 and APACHEⅡ scores in the death group were significantly higher than those in the survival group(all P<0.05),but serum complement C3 in the death group was significantly lower than that in the survival group(P<0.05).(4)Serum IL-35 and complement C3 were the influencing factors for the prognosis of patients with sepsis.Conclusion C3 and IL-35 can be used in the diagnosis and prognosis evaluation of sepsis,but the related mechanisms need to be further explored.