Study on the levels of main inflammatory factors in septic shock and their clinical significance / 中华危重病急救医学

ABSTRACT

Objective To explore the correlation between major inflammatory factors and septic shock in intensive care unit (ICU) patients, and to provide a basis for the diagnosis and treatment of septic shock. Methods The patients admitted to ICU of the Third People's Hospital of Datong from March 2017 to August 2018 were selected as the research objects. According to the diagnostic criteria of septic shock, the patients were divided into septic shock group and non-septic group. The basic information and inflammatory factors levels of the two groups, including age, gender, body mass index (BMI), course of disease, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), infection site and pathogenic; and C-reactive protein (CRP), procalcitonin (PCT), neutrophil lymphocyte ratio (NLR), N-terminal pro-B-type natriuretic peptide (NT-proBNP), tumor necrosis factor-α (TNF-α), γ-interferon (IFN-γ), interleukins (IL-1β, IL-2, IL-6, IL-8) at 8 hours after diagnosis, were compared. Logistic regression was used to analyze the influencing factors of septic shock in ICU patients. Results A total of 154 ICU patients were selected, of whom 74 had septic shock. The APACHEⅡ score of septic shock group was significantly higher than that of non-sepsis group (23.42±3.64 vs. 15.67±2.26, P < 0.05). There was no significant difference in other baseline data between the two groups. The levels of CRP, NT-proBNP, TNF-α, IFN-γ, PCT, IL-6, IL-8 in the septic shock group were significantly higher than those in the non-septic group [CRP (mg/L) 164.3±22.6 vs. 52.3±16.2, NT-proBNP (ng/L) 426.3±288.9 vs. 167.3±80.6, TNF-α (ng/L) 193.4±39.3 vs. 88.1±20.3, IFN-γ (ng/L) 133.3±52.0 vs. 97.0±56.1, PCT (ng/L)27.6±10.2 vs. 7.3±4.1, IL-6 (ng/L) 83.0±17.6 vs. 20.9±6.4, IL-8 (ng/L) 445.8±34.0 vs. 84.0±25.7, all P < 0.05]. It was shown by Logistic regression analysis that CRP, NT-proBNP, TNF-α, PCT, IL-6 were independent risk factors for septic shock [CRP odds ratio (OR) = 1.662, 95% confidence interval (95%CI) = 1.132-2.567; NT-proBNP OR = 14.688, 95%CI = 3.580-20.238; TNF-α OR = 1.093, 95%CI = 1.043-1.343; PCT OR = 6.378, 95%CI = 4.556-12.243; IL-6 OR = 9.641, 95%CI = 2.242-13.786; all P < 0.05]. Conclusion The levels of inflammatory factors CRP, NT-proBNP, TNF-α, PCT and IL-6 were significantly increased, which were important factors for early diagnosis of septic shock.