|
|
|
| Dynamic Monitoring of Immune-related Indicators to Assess Immune Function and Predict Disease Severity and Outcome in Critically Ill Patients |
| TAO Dan, LI Peng |
| First Affiliated Hospital of Xi'an Jiao Tong University Clinical Laboratory Shaanxi Xi'an 710061) |
|
|
|
|
Abstract 【Objective】To investigate the value of dynamic monitoring of immune-related indexes to evaluate immune function and predict disease severity and outcome in the critically ill patients. 【Methods】A total of 53 patients admitted to EICU of our hospital were selected in this study. According to the 28-day mortality, patients were divided into two groups: the survival group (n=36) and the death group (n=17). The peripheral venous blood on the 1st, 3rd, and 7th day after admission were collected for the inflammation indicators detection including interleukin-6 (IL-6),IL-8 and IL-10 and TNF-α, as well as the immunologically relevant indicators detection including PCT, hs-CRP, immunoglobulin (IgA, IgM, IgG), CD4+, CD8+, CD4+/CD8+. The patients' immune-related indicators were analyzed to assess critical immune function and predict the severity and outcome of the disease. 【Results】The IL-10 level in the survival group on the 3rd day of EICU was significantly lower than that in the death group (P<0.05). On the 7th day, the survival group had lower PCT level and higher levels of IL-6 and IL-8 than those of the death group (P<0.05). The levels of IgA, IgM and CD8+ in the survival group on the 1st day were significantly lower than those in the death group (P<0.05). The levels of CD4+ and CD4+/CD8+ on the 7th day in the survival group were significantly higher than those in the death group (P<0.05). The sensitivity and specificity of PCT (7th day), IL-10 (3rd day), CD8+, APACHE Ⅱ (acute physiology and chronic health status scoring system) score and SOFA (systemic infection-related organ failure evaluation system) score in the diagnosis of 28-day mortality in critically ill patients were relatively high (P<0.05). 【Conclusion】The immune dysfunction degree is negatively correlated with the prognosis of critically ill patients, which will increase the mortality rate. PCT, IL-10, and CD8+ can predict the risk of the poor prognosis and mortality.
|
|
Received: 06 November 2018
|
|
|
|
|
|
[1] 应芙蓉, 赵志超, 吕佳妤,等. 系统性炎症指标在深部真菌感染患者中检测的应用价值[J].中国卫生检验杂志, 2017(24):3502-3504.
[2] Prochnau D, Straube E, Figulla HR, et al. Supra-additive expression of interleukin-6, interleukin-8 and basic fibroblast growth factor in vascular smooth muscle cells following coinfection with Chlamydia pneumoniae and cytomegalovirus as a novel link between infection and atherosclerosis[J].Can J Infect Dis Med Microbiol,2016, 23(2):26-30.
[3] 李雄海, 王晓琴, 梁骑. 感染性肺炎患儿炎症反应及免疫功能相关指标水平变化及意义[J].海南医学院学报, 2017, 23(22):3146-3149.
[4] 周洪, 綦俊, 张奇,等. 外周血Th17细胞对脓毒症急性肺损伤病情严重程度及预后的评估价值[J].现代免疫学, 2016(2):113-117.
[5] Krzemień G, Szmigielska A, Turczyn A, et al. Urine interleukin-6, interleukin-8 and transforming growth factor β1 in infants with urinary tract infection and asymptomatic bacteriuria[J].Central-Eur J Imm,2016, 41(3):260-267.
[6] 何炳灵, 郭述良. 降钙素原与临床肺部感染评分对老年呼吸机相关性肺炎患者病情严重程度及预后的评估价值[J].医学研究杂志, 2016, 45(4):49-52.
[7] 王庭刚, 卢海滨. 外周血CD64指数对创伤手术后脓毒症病情严重程度及预后的评估价值[J].局解手术学杂志, 2017, 26(4):260-263.
[8] Grover H S, Kapoor S, Singh A. Effect of topical simvastatin (1.2 mg) on gingival crevicular fluid interleukin-6, interleukin-8 and interleukin-10 levels in chronic periodontitis -A clinicobiochemical study[J].J Oral Bio Craniofacial Res,2016, 6(2):85.
[9] 罗运山.动态监测血LAC、CRP及ScvO2水平对评估脓毒症预后的价值研究[J].人民军医, 2016(12):1239-1241.
[10] 赵大国, 徐华, 郭强,等. 重症肺炎患者的病情程度及预后与凝血系统功能相关分析及TEG指标的应用价值[J].贵州医药, 2018(1):100-102.
[11] Shimizu S, Kouzaki H, Kato T, et al. HMGB1-TLR4 signaling contributes to the secretion of interleukin 6 and interleukin 8 by nasal epithelial cells[J].Am J Rhinol Allergy,2016,30(3):167-172. |
|
|
|
2020, Vol. 37 
