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目的探讨IL-27在脓毒症早期诊断及判断预后中的价值。方法纳入2014年7月至2015年7月入住重症监护病房(ICU)的脓毒症患者和全身炎症反应综合征(SIRS)患者各30例,脓毒症患者中包括严重脓毒症患者15例。采用ELISA检测血清IL-27和降钙素原(PCT)浓度。并随访28 d观察预后。结果脓毒症组血清IL-27浓度明显高于SIRS组[(3.39±1.77)ng/m L vs(2.28±1.35)ng/m L,P<0.01)],以2.94 ng/m L为临界值,ROC曲线分析的曲线下面积(AUC)值为0.735,敏感性和特异性分别为70%和82%;IL-27联合PCT检测AUC值为0.901,敏感性和特异性分别为88%和96%。严重脓毒症患者IL-27浓度明显高于单纯脓毒症患者[(6.38±2.54)ng/m L vs(3.04±1.25)ng/m L,P<0.01],以4.71 ng/m L为临界值,其AUC值为0.769,敏感性和特异性分别为73%和80%。Logistic回归分析显示IL-27能有效评估患者预后(P<0.05)。结论IL-27有助于早期诊断脓毒症,联合PCT效果更好,并能有效判断脓毒症患者预后。
Objective To investigate the value of IL-27 in the early diagnosis and prognosis of sepsis. Methods Thirty patients with sepsis and 17 patients with systemic inflammatory response syndrome (SIRS) admitted to intensive care unit (ICU) from July 2014 to July 2015 were enrolled. Thirty sepsis patients included 15 patients with severe sepsis . Serum levels of IL-27 and procalcitonin (PCT) were measured by ELISA. The patients were followed up for 28 days to observe the prognosis. Results Serum IL-27 concentration in sepsis group was significantly higher than that in SIRS group [(3.39 ± 1.77) ng / m L vs (2.28 ± 1.35) ng / m L, P <0.01) The AUC of ROC curve analysis was 0.735 and the sensitivity and specificity were 70% and 82%, respectively. The AUC value of IL-27 combined with PCT was 0.901 and the sensitivity and specificity were 88% and 96%. The concentration of IL-27 in patients with severe sepsis was significantly higher than that in patients with sepsis alone [(6.38 ± 2.54) ng / m L vs (3.04 ± 1.25) ng / m L, P <0.01] and 4.71 ng / m L The cut-off value had an AUC value of 0.769 with a sensitivity and specificity of 73% and 80%, respectively. Logistic regression analysis showed that IL-27 could effectively evaluate the prognosis of patients (P <0.05). Conclusions IL-27 is helpful for the early diagnosis of sepsis. The combination of PCT and IL-27 is better and the prognosis of patients with sepsis can be effectively judged.