| 张剑杰,孙波,孙勤.早期血浆IL-6水平与多发伤患者预后关系的研究[J].浙江中西医结合杂志,2020,30(1): |
| 早期血浆IL-6水平与多发伤患者预后关系的研究 |
| The study of association of serum levels of IL-6 and its prognosis in patients with multiple trauma |
| 投稿时间：2019-06-27 修订日期：2019-11-30 |
| DOI： |
| 中文关键词: 白介素-6，多发伤，多器官功能障碍综合征 |
| 英文关键词:IL-6, multiple trauma, MODS |
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| 中文摘要: |
| 目的 探讨早期血浆白介素-6(interleukin-6,IL-6)水平与多发伤患者多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)及死亡率的关系,并明确IL-6是否可以作为预测多发伤患者发生MODS及死亡的指标。方法 将于2016年01月至2018年08月102例入住温州医科大学附属慈溪医院重症医学科的创伤严重度评分(ISS)＞16分的多发伤患者纳入该研究。对上述患者进行连续测定创伤后24、48、及72h的血浆IL-6水平,并进行连续14天的MODS评分。采用多元Logistic回归分析确定创伤后早期血浆IL-6的水平与MODS的发生及死亡之间的相关性。结果 发生MODS的多发伤患者的早期血浆IL-6水平升高明显(P＜0.05)。多发伤患者早期血浆IL-6峰值是MODS及死亡的独立预测因子(OR=1.11；95% CI：1.03～1.18,P=0.002；OR=1.29；95% CI：1.11～1.49,P=0.01)。而且,IL-6截点取151.76pg/mL时,预测MODS的敏感性0.870%,特异性0.937%；IL-6截点取151.36pg/mL时,预测死亡的敏感性0.842%,特异性0.880%。结论 IL-6的早期血浆水平可预测多发伤患者的死亡风险,并且可以作为识别MODS发生及死亡风险的有用的指标。 |
| 英文摘要: |
| Objective To investigate the relationship between of the serum level of interleukin-6(IL-6) and multiple organ dysfunction syndrome (MODS) and mortality in patients with multiple trauma at the early stage. And identify whether the serum level of IL-6 play the indicator of predicting development of MODS and death in patients with multiple trauma. Methods A total of 102 patients with an injury severity score≥16 admitted to Hangzhou Cancer Hospital Intensive Care Unit between January 2016 and August 2018 were prospectively included in this study. The serum IL-6 levels were measured at 24, 48 and 72 hours after trauma respectively, and Marshall Score for MODS was calculated for at least 14 days. The relationship between the early serum concentration of IL-6 and development of MODS and death were analyzed by multiple Logistic regression. Results The serum levels of IL-6 were higher in patients with MODS(P＜0.05) at the early stage. IL-6 was an independent predictor for MODS and mortality(odd ratio =1.11；95% confidence interval: 1.03～1.18,P=0.002；odd ratio =1.29；95% confidence interval：1.11～1.49,P=0.01). The cutoff value for development of MODS was 151.76pg/mL(0.870% sensibility and 0.937% specificity) and 151.36pg/mL (0.842% sensibility and 0.880% specificity) for mortality during the inpatient time. Conclusion The serum IL-6 at the early stage after multiple trauma could predict the risk of death and be used as an effective indicator to identify development of MODS and death in patients with multiple trauma. |
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