目的 观察血清白细胞介素-6（IL-6）、IL-8、髓系细胞触发受体1（TREM1）、尿激酶型纤溶酶原激活物受体（uPAR）和前脓毒素（presepsin）在脓毒症休克患者中的变化，并分析其诊断价值。 方法 前瞻性地选取2023年2月至2025年2月医院收治的150例脓毒症患者作为研究对象，依据病情分为脓毒症（非休克）组（n = 44）和脓毒症休克组（n = 106）。另择同期各项指标正常的30例健康人作为对照组。比较不同人群血清IL-6、IL-8、TREM1、uPAR和presepsin的水平，采用Spearman 相关性分析、logistic回归分析分析血清指标与脓毒症病情的相关性，采用受试者工作特征（ROC）曲线评估血清指标诊断脓毒症休克的效果。 结果 不同人群血清IL-6、IL-8、TREM1、uPAR及presepsin比较均有差异（P < 0.05），呈现脓毒症休克组 > 脓毒症组 > 对照组（P < 0.05）的趋势。脓毒症休克患者急性生理学和慢性健康状况评价Ⅱ（APACHE Ⅱ）、序贯器官衰竭估计评分（SOFA）评分均高于脓毒症患者（P < 0.05）。Spearman相关性分析结果显示：血清IL-6、IL-8、TREM1、uPAR及presepsin与APACHE Ⅱ评分、SOFA评分均呈正相关，r_s 为0.758、0.880、0.837、0.832、0.846、0.487、0.549、0.557、0.626、0.664（P < 0.05）。logistic回归模型结果显示：血清IL-6（OR = 1.055）、IL-8（OR = 1.054）、TREM1（OR = 1.038，95%）、uPAR（OR = 1.010）和presepsin（OR = 2.103）均与脓毒症休克的发生显著相关（P < 0.05）。ROC曲线结果显示，血清IL-6、IL-8、TREM1、uPAR和presepsin诊断脓毒症休克的AUC为0.608、0.724、0.887、0.848、0.885，敏感度为0.432、0.909、0.795、0.909、0.591，特异度为0.880、0.481、0.915、0.736、0.977，多项联合后其诊断脓毒症休克的AUC为0.973，敏感度为0.943，特异度为0.953。且presepsin单独诊断脓毒症休克的AUC高于IL-6、IL-8 单独诊断脓毒症休克的AUC（P < 0.05），多项联合诊断脓毒症休克的AUC均高于血清IL-6、IL-8、TREM1、uPAR和presepsin单独诊断脓毒症休克的AUC（P < 0.05）。 结论 血清IL-6、IL-8、TREM1、uPAR和presepsin在脓毒症休克患者中异常升高，可辅助临床诊断脓毒症休克，5项联合可提升对脓毒症休克的诊断效果。

Objective To observe the dynamic changes in serum levels of IL-6， IL-8， TREM-1， uPAR， and presepsin in patients with septic shock and to analyze the diagnostic significance of these biomarkers. Methods A total of 150 sepsis patients admitted to the hospital between February 2023 and February 2025 were prospectively enrolled as study subjects. According to their clinical conditions， the participants were categorized into a sepsis group （non-shock， n = 44） and a septic shock group （n = 106）. Additionally， 30 healthy individuals with normal clinical indicators during the same period were selected as the control group. The serum levels of IL-6， IL-8， TREM-1， uPAR， and presepsin were measured and compared across the different groups. Spearman correlation analysis and logistic regression analysis were conducted to assess the association between these biomarkers and the severity of sepsis. The diagnostic performance of these biomarkers for septic shock was evaluated using receiver operating characteristic （ROC） curve analysis. Results There were statistically significant differences in serum levels of IL-6， IL-8， TREM1， uPAR， and presepsin among the different groups （P < 0.05）， with the highest values observed in the septic shock group， followed by the sepsis group and the control group （P < 0.05）. The APACHE Ⅱ and SOFA scores of patients with septic shock were significantly higher than those of patients with sepsis （P < 0.05）. Spearman correlation analysis revealed that serum concentrations of IL-6， IL-8， TREM1， uPAR， and presepsin were positively correlated with both APACHE Ⅱ and SOFA scores， with correlation coefficients （rs） of 0.758， 0.880， 0.837， 0.832， and 0.846 for APACHE Ⅱ score， and 0.487， 0.549， 0.557， 0.626， and 0.664 for SOFA score， respectively （P < 0.05）. Logistic regression analysis indicated that serum levels of IL-6 （OR = 1.055）， IL-8 （OR = 1.054）， TREM1 （OR = 1.038）， uPAR （OR = 1.010）， and presepsin （OR = 2.103） were significantly associated with the development of septic shock （P < 0.05）. ROC curve analysis demonstrated that the AUC values for serum IL-6， IL-8， TREM1， uPAR， and presepsin in diagnosing septic shock were 0.608， 0.724， 0.887， 0.848， and 0.885， with corresponding sensitivities of 0.432， 0.909， 0.795， 0.909， and 0.591， and specificities of 0.880， 0.481， 0.915， 0.736， and 0.977， respectively. When these biomarkers were combined， the AUC increased to 0.973， with a sensitivity of 0.943 and a specificity of 0.953. Furthermore， the AUC for presepsin alone was significantly higher than that for IL-6 and IL-8 alone （P < 0.05）. Additionally， the AUC for the combined biomarkers was significantly greater than that for each biomarker individually （P < 0.05）. Conclusions Serum levels of IL-6， IL-8， TREM1， uPAR， and presepsin are significantly elevated in patients with septic shock， which may aid in the clinical diagnosis of the condition. The combined use of these five biomarkers enhances the accuracy of diagnosing septic shock.