收稿日期: 2024-01-22
网络出版日期: 2024-06-14
基金资助
国家自然科学基金资助项目(81960342)
Interferon-γ Correlation with the severity of septic shock in patients and its prognostic value
Received date: 2024-01-22
Online published: 2024-06-14
目的 探讨γ干扰素（interferon gamma， IFN-γ）的表达水平和脓毒性休克（septic shock）患者病情严重程度的相关性及其对预后的评估价值。 方法 收集96例脓毒性休克患者的临床资料及血清，并按28 d结局分为存活组和死亡组；同时收集同期健康体检人群的30例血清作为对照组。采用酶联免疫吸附（ELISA）法检测3组的IFN-γ的表达水平，分析组间IFN-γ的表达水平及各项临床资料。 结果 脓毒性休克患者血清的IFN-γ表达水平较健康体检人群低［212.80（151.11，255.79）ng/L vs. 343.37（314.5，427.95）ng/L，P < 0.01］。96例脓毒性休克中有54例存活组，42例死亡组，比较两组的临床资料，两组患者的性别、吸烟史、SBP、DBP、SI、Lac、IL-6、IFN-γ、PCT、SOFA评分、APACHEⅡ评分比较差异有统计学意义（P < 0.01）。logistic回归分析显示提示Lac、IFN-γ表达下降、APACHEⅡ评分是脓毒性休克患者死亡的独立危险因素［优势比（OR）和95%置信区间（95%CI）分别为6.491（1.404 ~ 30.004）、0.954（0.954 ~ 0.999）、3.476（1.210 ~ 9.984），P < 0.05］。INF-γ和Lac、APACHEⅡ的Spearman相关性分析呈负相关，相关系数分别为-0.38、-0.35。绘制Lac、IFN-γ、APACHEⅡ的ROC曲线，三者的AUC分别为0.847、0.869、0.833，三者联合预测的AUC为0.978，三者联合预测的价值优于单一指标（P < 0.001）。 结论 IFN-γ表达水平下降与脓毒性休克患者的严重程度呈正相关，对预后有较好的评估价值。
黄立创 , 蒋良艳 , 张碧霞 , 吴绍雷 , 胡军涛 , 汤展宏 . γ干扰素与脓毒性休克患者严重程度的相关性及对预后的评估价值[J]. 实用医学杂志, 2024 , 40(12) : 1725 -1730 . DOI: 10.3969/j.issn.1006-5725.2024.12.019
Objective To explore the correlation between the expression level of interferon gamma （IFN-γ） and the severity of patients with septic shock and its prognostic value. Methods The clinical data and serum of 96 septic shock patients admitted to the Department of Critical Care Medicine， the First Affiliated Hospital of Guangxi Medical University from March 2022 to August 2023 were collected， and divided into survival group and death group according to the 28-day outcome； collected at the same time Sera from 30 healthy people undergoing physical examination during the same period served as the control group. The enzyme-linked immunosorbent （ELISA） method was used to detect the expression levels of IFN-γ in the three groups， and the expression levels of IFN-γ and various clinical data between the groups were analyzed. Results The serum IFN-γ expression level of patients with septic shock was lower than that of healthy people undergoing physical examination， 212.80 （151.11， 255.79） ng/L compared with 343.37 （314.5， 427.95） ng/L， P < 0.01. Among the 96 cases of septic shock， There were 54 cases in the survival group and 42 cases in the death group. The clinical data of the two groups were compared. The gender， smoking history， SBP， DBP， SI， Lac， IL-6， IFN-γ， PCT， SOFA score， and APACHEⅡscore of the two groups of patients were compared. The difference is statistically significant （P < 0.01）. Logistic regression analysis showed that decreased expression of Lac， IFN-γ， and APACHEⅡ score were independent risk factors for death in patients with septic shock. ［Odds ratio （OR） and 95% confidence interval （95%CI） were 6.491 （1.404 ~ 30.004） respectively. 0.954 （0.954 ~ 0.999）， 3.476 （1.210 ~ 9.984）， P < 0.05］. The Spearman correlation analysis of INF-γ， Lac and APACHEⅡ showed a negative correlation， and the correlation coefficients were -0.38 and -0.35 respectively. Drawing the ROC curves of Lac， IFN-γ， and APACHEII， the AUCs of the three were 0.847， 0.869， and 0.833 respectively. The AUC of the three joint predictions was 0.978. The joint prediction value of the three was better than that of a single indicator， P < 0.001. Conclusion The decrease in IFN-γ expression level and the severity of septic shock patients have good prognostic value.
Key words： sepsis; septic shock; IFN-γ; prognosis
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