Detection Of Multiple Biomarkers To Comprehensively Evaluate The Immune Status And Prognosis Of Patients With Sepsis

Objective: The combined detection of biomarkers is used to evaluate the immune status and prognosis of patients with sepsis,so as to provide a new support point for the personalized diagnosis and treatment of sepsis.Methods:According to the diagnostic criteria of "sepsis 3.0" launched by the third International consensus Conference,44 patients who were admitted to the intensive care unit of the emergency department of our hospital from February 2019 to February2020 were included in the diagnosis of sepsis,and 12 non-septic patients in the same period were selected as the control group.According to the 28-day outcome of the patients,the patients with sepsis were divided into two subgroups: death group(n = 20)and survival group(n = 24).Within 24 hours after all hospitalized patients were diagnosed,blood samples were taken and their serum biomarkers,including inflammatory factors interleukin-l β(IL-1 β),interleukin 6(interleukin-6,IL-6)and interleukin 10(interleukin-10,),were detected.The values of IL-10,procalcitonin(Procalcitonin,PCT),C-reactive protein(C-reactive protein,CRP)and nod-like receptor protein 3(NOD-like receptor protein3,NLRP3),hypoxia-inducible factor-1 α(Hypoxia inducible factor-1 α(HIF-1 α)and lactic acid(Lactic acid,Lac)were measured.Through the expression level of various biomarkers,we can comprehensively evaluate the condition of patients with sepsis,accurately grasp the immune status of patients,and give patients timely and reasonable treatment to reduce the death of patients.At the same time,the organ dysfunction was evaluated according to the sequential inertia organ failure score(SOFA)and the acute physiology and chronic health score system(APACHEII).Finally,the changes of biomarkers were compared with the changes of biomarkers in each group to understand the relationship between the changes of biomarkers and the prognosis of the disease.Results:1.The levels of pro-inflammatory cytokines(IL-1 β,IL-6,PCT,CRP)and anti-inflammatory cytokines(IL-10)in patients with sepsis and septic shock were significantly higher than those in patients with non-sepsis,indicating that the patients were in a disorder of pro-inflammatory / anti-inflammatory response.2.The level of biomarker NLRP3 in septic shock group is higher than that in septic group and non-septic group,which may be related to the severity of the disease.3.The level of biomarker HIF-1 α in septic shock group was higher than that in septic group,but there was no significant difference between shock group and septic group(P > 0.05),suggesting that it may be related to the severity of the disease,but it needs to be fully demonstrated by further expanding the sample size.4.Biomarkers NLRP3 and HIF-1 α combined with inflammatory factors can comprehensively evaluate the immune status of patients with sepsis,which has the potential to identify sepsis in the early stage,evaluate the disease and judge the prognosis.Conclusion:1.The comprehensive evaluation of immune status of patients with NLRP3 and HIF-1 α combined with inflammatory factors may have the potential to identify,evaluate and judge the prognosis of sepsis in the early stage.2.When the levels of NLRP3 and pro-inflammatory cytokines were highly expressed,it suggested that the patients might be in a state of high inflammatory response.3.Biomarker NLRP3 may have a certain role in early diagnosis,evaluation of disease severity and prognosis in sepsis,and may provide a new basis for clinical diagnosis and treatment.