IL-8和GRO-α与U-HBP评估ICU脓毒症患者预后的临床价值

Clinical value of IL-8,GRO-αand U-HBP in assessment of prognosis of ICU patients with sepsis

目的探讨白细胞介素-8(IL-8)、C-反应蛋白(CRP)、生长调节癌基因-α(GRO-α)和尿肝素结合蛋白(U-HBP)对ICU脓毒症患者病情预后的评估价值。方法选取2018年2月-2021年2月日照市中心医院ICU收治的脓毒症患者266例为研究对象,多因素Logistic回归分析ICU脓毒症患者预后不良的危险因素;收集纳入研究对象入组时IL-8、CRP、GRO-α和U-HBP水平;受试者工作特征(ROC)曲线评估上述4项指标对脓毒症患者预后的预测价值。结果多因素Logistic分析结果显示:液体出入负平衡、国家早期预警评分(NEWS)、脓毒症相关的序贯器官衰竭评分(SOFA)为脓毒症患者预后不良的独立危险因素;脓毒症、严重脓毒症及脓毒症休克患者IL-8、CRP、GRO-α、U-HBP水平比较有统计学差异(P<0.05),并随病情严重程度逐渐升高(P<0.05);脓毒症预后不良组患者IL-8、CRP、GRO-α和U-HBP水平高于预后良好组(P<0.05);ROC曲线结果显示,IL-8、CRP、GRO-α和U-HBP联合预测脓毒症患者预后的曲线下面积(AUC)为0.824,敏感度为86.67%、特异度为66.99%。结论脓毒症患者血清IL-8、CRP、GRO-α和U-HBP水平可反映脓毒症患者病情的严重程度,且对ICU脓毒症患者的预后判断有临床研究价值。

OBJECTIVE To explore the values of interleukin-8(IL-8),C-reactive protein(CRP),growth-regulating oncogene-α(GRO-α)and urinary heparin-binding protein(U-HBP)in assessment of prognosis of the ICU patients with sepsis.METHODS A total of 266 patients with spies who were treated in ICUs of Rizhao Central Hospital from Feb 2018 to Feb 2021 were recruited as the research subjects.Multivariate logistic regression analysis was performed for risk factors for poor prognosis of the ICU patients with sepsis.The levels of IL-8,CRP,GRO-αand U-HBP of the enrolled research subjects were detected at the enrollment,and the values of the four indexes in prediction of the prognosis were assessed by means of receiver operating characteristic(ROC)curve.RESULTS The result of multivariate logistic analysis showed that negative balance of fluid in and out,national early warning score(NEWS)and sepsis-associated sequential organ failure assessment(SOFA)were the independent risk factors for poor prognosis of the sepsis patients.There were significant differences in the levels of IL-8,CRP,GRO-αand U-HBP among the patients with sepsis,the patients with severe sepsis and the patients with septic shock(P<0.05),and the levels of the indexes were elevated with the severity of disease(P<0.05).Among the patients with sepsis,the levels of IL-8,CRP,GRO-αand U-HBP of the poor prognosis group were higher than those of the favorable prognosis group(P<0.05).ROC curve analysis showed that the area under curve(AUC)of the joint detection of IL-8,CRP,GRO-αand U-HBP was 0.824 in prediction of prognosis of the spies patients,with the sensitivity 86.67%,the specificity 66.99%.CONCLUSION The levels of serum IL-8,CRP,GRO-αand U-HBP of the sepsis patients may reflect the illness condition of the sepsis patients and have clinical value in prediction of prognosis of the ICU patients with sepsis.