Role of combined monitoring on serum interleukin in the assessment of septic severity and prognosis

Abstract:

Objective：To analyze the characteristics of interleukin-1（IL-1），interleukin-6 （IL-6），interleukin-8（IL-8） and inter－leukin-10（IL-10） in patients with different septic severity as well as its prognosis，providing clinical references to assess the severity and outcome of sepsis. Methods：A total of 71 septic patients in our department from March 2016 to August 2017 were enrolled. On the basis of severity of sepsis，patients were divided into the sepsis group（n=37） and the septic shock group（n=34）. In addition，they were divided into the survival group（n=58） and the death group（n=13） according to the 28-day outcome. Sequential organ failure assessment（SOFA） and acute physiology and chronic health e－valuationⅡ（APACHEⅡ） were recorded when patients entered the intensive care unit（ICU）. Procalcitonin（PCT），c-reactive protein（CRP），IL-1，IL-4，IL-6 and IL-8 were measured. The difference of above indexes between the sepsis group and the septic shock group was compared，and the clinical value of these indexes in evaluating the prognosis of patients was analyzed by ap－plying the receiver operating characteristic（ROC）. Results：Scores of SOFA（P=0.001），APACHEⅡ（P=0.001），CRP（P=0.019），IL-1（P=0.001），IL-6（P=0.004），IL-8（P=0.001） and IL-10（P=0.001） in the septic shock group were significantly higher than those in the sepsis group，all differences with statistical significances（P<0.05）. Serum PCT level（P=0.325） between the septic shock group and the sepsis group had no significant difference. According to the 28-day outcome，results showed that scores of SOFA（P=0.001），APACHEⅡ（P=0.001），IL-1（P=0.037） and IL-8（P=0.035） in the death group were significantly higher than those in the survival group（P<0.05），all differences with statistical significances. However，CRP（P=0.544），IL-6（P=0.586） and IL-10（P=0.676） in the evaluation of prognosis of septic patients had no significant differences. According to ROC curve，IL-1（area under curve，AUC=0.657） and IL-8（AUC=0.689） was able to reflect the prognosis of patients，but its predictive value was lower than the SOFA score（AUC=0.853） and the APACHEⅡ score（AUC=0.843）. Combined monitoring IL-1 and IL-8（AUC=0.704） had higher value to assess the prognosis than individual monitoring. Conclusion：The CRP，IL-1，IL-6，IL-8 and IL-10 have correlation with sepsis severity，which are of potential value in judging the severity of sepsis. Combined monitoring IL-1 and IL-8 can reflect the prognosis of sepsis patients.