Several Cytokines and Protein C Levels with the Apache II Scoring System for Evaluation of Patients with Sepsis.
Several Cytokines and Protein C Levels with the Apache II Scoring System for Evaluation of Patients with Sepsis.
复制标题
使用 Apache II 评分系统评估脓毒症患者的几种细胞因子和蛋白 C 水平。
作者：
E. Kartal;Emine Karkaç;Z. Gülbaş;S. N. Alpat;N. Erben;E. Çolak
目标
我们研究了测定基线时的 IL-6、IL-8、IL-1β 和 TNF-α、入院时和开始后 48 小时的总蛋白 C (PC) 水平是否可以补充急性生理学和慢性健康评估 (APACHE) II 评分系统，以识别败血症、严重败血症或败血性休克患者的临床结果。
材料和方法
该研究是前瞻性进行的。连续 60 名脓毒症、严重脓毒症或脓毒性休克患者被纳入研究。在基线和开始后 48 小时采集血样。使用酶联免疫吸附测定 (ELISA) 测量血浆中的细胞因子和 PC 水平。 APACHE II 分数在入院时计算。
结果
开始后 48 小时的基线 IL-6 水平和 PC 水平可预测死亡率增加（分别为 p=0.016、p=0.044）。基线 IL-6、IL-8 和 TNF-α 基线水平与生理损伤的严重程度相关，由 APACHE II 评分确定。然而，我们对这些数据的多重逻辑回归分析并没有显示出与 APACHE II 评分相结合的任何预测价值。
结论
开始后 48 小时测定基线 IL-6 和 PC 对于脓毒症患者的预后评估具有预测价值，但并没有显着提高 APACHE 评分系统识别脓毒症患者致命临床结果的预测能力。
OBJECTIVE
We investigated whether determination IL-6, IL-8, IL-1beta and TNF-alpha at baseline, total protein C (PC) levels at time of admission and 48 hours after initiation could complement the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system to identify patients with sepsis, severe sepsis or septic shock for clinical outcome.
MATERIAL AND METHODS
The study was carried out prospectively. 60 consecutive patients with sepsis, severe sepsis or septic shock were included. Blood samples were obtained at baseline and 48 hours after initiation. Cytokines and PC levels in plasma were measured with an enzyme-linked immunoabsorbent assay (ELISA). APACHE II score was calculated on admission.
RESULTS
Baseline IL-6 levels and PC levels 48 hours after initiation were predictive of increased mortality (p=0.016, p=0.044 respectively). Baseline IL-6, IL-8 and TNF-alpha baseline levels correlate with the severity of physiologic insult, as determined by the APACHE II score. However, our multiple logistic regression analysis of these did not reveal any predictive value in combination with the APACHE II score.
CONCLUSION
Determination of baseline IL-6 and PC 48 hours after initiation were of predictive value for prognostic evaluation of septic patients, but did not significantly increase predictive power of the APACHE scoring system to identify patients with sepsis for fatal clinical outcome.
影响因子：
9.6
作者：
KNAUS, WA;WAGNER, DP;HARRELL, FE
通讯作者：
HARRELL, FE