The Effect Of IL-27 In Early Diagnosing,Deter Mining Severity And Predicting Outcome Of Sepsis

Objective:To detect the effect of IL-27 in early diagnosing sepsis,evaluating the severity of sepsis and predicting the outcome. Methods:Patients with diagnosis of SIRS in the Intensive Care Unit(ICU) between July, 2014 and July, 2015 were enrolled in this study. Patient age: 18 to 70 years. The diagnosis of SIRS accorded to the International sepsis criteria drafted in 2001. Infection screening would be taken at the day when patient entered into ICU. Patients with positive culture or X ray indicated infection would be diagnosed of sepsis and divided into sepsis group, other patients would be divided into SIRS group. According to the severity of sepsis, patients in the sepsis group would be divided into sepsis, severe sepsis and septic shock. 5ml blood sample wo uld be taken at 1,3,7 days after patients entered into ICU. Then, the samples would be centrifuged, and the serum would be collected with EP piped and stored at-40 oC. Serum IL-27, PCT and CRP would be tested after all samples were collected with ELISA, ELFA and Immune turbidity method, respectively. Besides, the characteristics of patients would be collected, including age, gender, temperature, WBC and APACHEⅡ. The prognosis of 28 days would also be collected. The differences of IL-27, PCT and CRP between two groups would be analyzed with t test. The differences of biomarkers among 1, 3, 7 days and sepsis, severe sepsis, septic shock would be analyzed with one-way ANOVA. Receiver operating characteristic curve(ROC) would be used to evaluate the diagnostic value of each biomarker. Pearson correlation coefficient would be used to test the relationship between each biomarker and APACHEⅡ. Cox regression would be used to analyze the value of each biomarker in predicting the outcome. Results:118 patients were enrolled in this study, 75 in the sepsis group and 43 in the SIRS group. In the sepsis group, 53 patients were sepsis, 14 patients were severe sepsis and 8 patients were septic shock. IL-27 and PCT in the sepsis group(3.19±1.11ng/ml and 2.22±1.06ng/ml, respectively) were significant higher than in the SIRS group(2.43±0.76ng/ml and 1.22±0.69ng/ml, respectively) at first day.(P<0.01) There was no significant difference in CRP between two groups.(P>0.05) IL-27 and PCT were gradually declined with the progress of treatment.(P<0.05) The change in CRP was not significant.(P>0.05) There also no significant changes in the SIRS group.(P>0.05) The AUC of IL-27 was 0.65(Sensitivity: 66%; Specificity:72%). The AUC of PCT was 0.836(Sensitivity: 75%; Specificity:86%). The AUC of CRP was 0.589(Sensitivity: 53%; Specificity: 66%). In the sepsis group, IL-27 and PCT were both related to APACHEⅡ(R2=0.6585 and 0.8265, respectively). IL-27 and PCT were related to mortality, and the accuracy were 68% and 76.4%, respectively. Conclusion:IL-27 is a helpful biomarker in early diagnosing sepsis, evaluating the severity and predicting the outcome. However, its performance is poorer than PCT. More randomized controlled trails with large samples are still be needed to detect the real value of IL-27 in the future.