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目的:探究脓毒症患者血清炎症因子与序贯器官衰竭评估(SOFA)评分的关系,从而有助于评价患者病情严重程度,科学判断预后效果。方法:选择2014年1月至2015年12月期间在本院内接受治疗的脓毒血症患者142例作为研究对象。入院后24 h内患者进行血清炎症因子IL-6、PCT、CRP水平测定,同时进行SOFA评分。按照患者在入院治疗28天内生存结局状况进行分组,分别为死亡组(87例)和存活组(55例),另按照患者合并多器官功能障碍综合症(MODS)与否,分为MODS组(76例)和非MODS组(66例),对比不同组别间IL-6、PCT、CRP及SOFA评分差别;对比不同SOFA评分患者血清IL-6、PCT、CRP水平差异,分析其相关性。结果:IL-6、PCT以及SOFA评分比较,死亡组高于存活组,MODS组高于非MODS组,差异有统计学意义(P<0.05);SOFA评分越高,血清IL-6、PCT水平越高,差异有统计学意义(P<0.05);SOFA评分升高,患者病死率显著增加,SOFA>10分,病死率为78.3%,差异有统计学意义(P<0.05);Spearman相关分析结果显示,SOFA评分与血清IL-6水平呈显著正相关关系(r=0.261,P=0.012),与血清PCT水平呈正相关关系(r=0.453,P=0.000),SOFA与CRP水平无相关性(r=0.112,P=0.323)。结论:血清IL-6、PCT水平与SOFA评分具有相关性,可以在脓毒症患者病情严重程度及预后状况判断中作为生物学指标进行常规监测。
Objective: To explore the relationship between serum inflammatory factors and sequential organ failure assessment (SOFA) score in patients with sepsis so as to evaluate the severity of patients and judge the prognosis of patients with sepsis. METHODS: A total of 142 patients with sepsis admitted to our hospital from January 2014 to December 2015 were selected as study subjects. Patients within 24 h after admission serum inflammatory cytokines IL-6, PCT, CRP levels were measured, while SOFA score. The patients were divided into death group (87 cases) and survival group (55 cases) according to the survival outcome within 28 days after admission. The patients were divided into MODS group (MODS group and control group) according to the patients with multiple organ dysfunction syndrome (MODS) 76 cases) and non-MODS group (66 cases). The differences of IL-6, PCT, CRP and SOFA among different groups were compared. The differences of serum IL-6, PCT and CRP levels between different SOFA scores were analyzed. Results: The levels of IL-6, PCT and SOFA in the death group were higher than those in the survival group and those in the MODS group were higher than those in the non-MODS group (P <0.05). The higher the SOFA score, the higher the serum IL-6 and PCT levels (P <0.05); SOFA score increased, the patient mortality increased significantly, SOFA> 10, the mortality rate was 78.3%, the difference was statistically significant (P <0.05); Spearman correlation analysis The results showed that SOFA score was positively correlated with serum IL-6 level (r = 0.261, P = 0.012), positively correlated with serum PCT level (r = 0.453, P = 0.000) (r = 0.112, P = 0.323). Conclusion: Serum levels of IL-6 and PCT are correlated with SOFA scores and can be routinely monitored as a biological indicator in the severity and prognosis of septic patients.