GDF-15联合IL-6对脓毒症患者预后的评估价值研究

doi:10.3969/j.issn.1002-1949.2018.04.015

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摘要目的评估血清生长分化因子-15（GDF-15）联合白细胞介素-6（IL-6）在预测脓毒症不良预后的价值。方法选取2016-11~2017-11我院EICU收治的79例脓毒症患者以及同时期67例无脓毒症患者。比较两组间降钙素原（PCT）、C反应蛋白（CRP）、IL-6、GDF-15及急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）、序贯器官衰竭评分（SOFA）等指标的差异，以及GDF-15与器官功能衰竭指标的相关性。运用ROC曲线比较GDF-15与PCT、CRP、IL-6以及不同组合在判断脓毒症预后的价值。结果两组PCT、CRP、IL-6、GDF-15、APACHEⅡ、SOFA等指标比较差异有统计学意义（P＜0.05）。相关性分析结果显示，GDF-15与肾功能障碍标志物如肌酐和sCysC、肝脏功能障碍标志物如胆红素和白蛋白、凝血酶原时间、D-二聚体、NT-proBNP均显著相关（P＜0.05），与疾病严重程度评分呈正相关（P<0.001）。与炎症反应标志物如CRP、PCT、IL-6均密切相关（P<0.001）。ROC分析显示，IL-6曲线下面积（AUC）为0.899（95％CI 0.825~0.984），敏感度和特异度分别为90%和89%，较CRP、PCT和GDF-15显著升高（P＜0.001）；联合诊断显示，IL-6、CRP和PCT联合GDF-15后较单独诊断的AUC均有显著升高（P＜0.001），其中IL-6+GDF-15的AUC最高为0.926（0.874~0.981），敏感度和特异度分别为91%和93%（P＜0.001）。结论 GDF-15与脓毒症中器官衰竭有关，IL-6与GDF-15联合检测对评估脓毒症预后具有较高敏感度和特异度。

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	王理

关键词 ：脓毒症, 血清生长分化因子-15（GDF-15）, 白细胞介素-6（IL-6）, 降钙素原(PCT)

作者简介: 王理(1986-)，男，硕士研究生，E-mail:z2wangli@zju.edu.cn。

引用本文:

王理. GDF-15联合IL-6对脓毒症患者预后的评估价值研究[J]. 中国急救医学, 2018, 38(4): 345-.
Wang Li. Evaluation of the prognostic value of GDF-15 combined with IL-6 in patients with sepsis. Chinese Journal of Critical Care Medicine, 2018, 38(4): 345-.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.04.015 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I4/345

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