IL-37、PCT和CRP联合检测对急诊脓毒症患者28天预后的评估价值

The value of combined detection of IL-37,PCT and CRP in evaluating the 28-day prognosis of patients with emergency sepsis

目的回顾性分析早期白细胞介素-37(interleukin-37,IL-37)联合降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)对急诊脓毒症患者28 d预后的评估价值。方法选取2021年10月—2023年8月南京医科大学附属淮安第一医院急诊科收治的109例脓毒症患者,根据脓毒症患者28 d生存情况分为存活组85例和死亡组24例。分别比较两组患者的基础疾病、感染部位、IL-37、PCT、CRP、急性生理与慢性健康评分(acute physiology and chronic health status scoreⅡ,APACHEⅡ)及序贯性器官功能衰竭评分(sequential organ failure assessment,SOFA)。采用二元logistic回归分析影响脓毒症患者28 d预后的危险因素,受试者工作特征曲线(receiver operating characteristic curve,ROC)统计分析IL-37、PCT、CRP单独检测及联合检测对脓毒症患者28 d预后的评估价值。结果死亡组患者的SOFA评分、APACHEⅡ评分、IL-37、PCT、CRP水平均明显高于存活组,差异有统计学意义(P<0.05);死亡组与存活组之间的高血压、糖尿病、脑梗死、肿瘤等基础疾病和感染部位的差异无统计学意义(P>0.05);进一步二元logistic回归分析发现,IL-37、PCT、CRP为急诊脓毒症患者28 d病死率的独立预测因素(P<0.05)。ROC曲线结果分析显示,IL-37、PCT、CRP三者联合检测对急诊脓毒症患者28 d预后的评估价值明显优于两者联合检测和单独检测的评估价值,其曲线下面积分别为0.783(IL-37)、0.796(PCT)、0.804(CRP)、0.886(IL-37+PCT)、0.877(IL-37+CRP)、0.899(PCT+CRP)、0.912(IL-37+PCT+CRP)。结论IL-37、PCT、CRP对急诊脓毒症患者28 d预后具有重要的评估价值,且三者联合检测的评估价值明显高于单独检测及两者联合检测的评估价值。

Objective To retrospectively analyze the value of early interleukin-37(IL-37)combined with procalcitonin(PCT)and C-reactive protein(CRP)in evaluating the 28-day prognosis of emergency sepsis patients.Methods A total of 109 patients with sepsis admitted to the Emergency Department of Huai'an First Hospital Affiliated to Nanjing Medical University from October 2021 to August 2023 were selected and divided into a survival group of 85 patients and a death group of 24 patients based on their 28-day survival status.The basic diseases,infection site,IL-37,PCT,CRP,acute physiology and chronic health status scoreⅡ(APACHEⅡ)and sequential organ failure assessment(SOFA)were compared between the two groups,respectively.Binary logistic regression was used to analyze the risk factors affecting the 28-day prognosis of patients with sepsis.The receiver operating characteristic curve(ROC)was used to statistically analyze the evaluation value of IL-37,PCT,and CRP alone and in combination for the 28-day prognosis of patients with sepsis.Results The levels of SOFA score,APACHEⅡscore,IL-37,PCT and CRP in the death group were significantly higher than those in the survival group(P<0.05).There was no significant difference between the death group and the survival group in hypertension,diabetes,cerebral infarction,tumor and other basic diseases and infection sites(P>0.05).Further binary logistic regression analysis revealed that IL-37,PCT,and CRP were independent predictors of 28-day mortality in emergency sepsis patients(P<0.05).The analysis of ROC curve results shows that the combined detection of IL-37,PCT,and CRP has a significantly better evaluation value for the 28-day prognosis of emergency sepsis patients than the combined and individual detection of the two.The area under the curve was 0.783(IL-37),0.796(PCT),0.804(CRP),0.886(IL-37+PCT),0.877(IL-37+CRP),0.899(PCT+CRP),and 0.912(IL-37+PCT+CRP),respectively.Conclusion IL-37,PCT,and CRP have important evaluation value for the 28-day prognosis of patients with emergency sepsis,and the evaluation value of IL-37,PCT,and CRP is significantly higher than that of individual detection and their combined detection.