The Value Of Cytokines In The Diagnosis Of Infectious Diseases And Their Severity

Objectives:To investigate the value of cytokines in predicting the early diagno sis of infectious diseases and to identify the value of cytokines in stratifying t he severity of sepsis.Methods:A prospective study was conducted on patients with infectious diseas es admitted to the ICU in building 3,the first affiliated hospital of kunming medical university from December 2019 to March 2020.According to the result s of blood culture,sputum culture,urine culture and macro factor test,the pati ents were divided into gram staining positive bacteria group/gram staining nega tive bacteria group,blood borne infection group and non-blood borne infection group.According to the Chinese guidelines for emergency treatment of sepsis a nd septic shock(2018),the patients were divided into the sepsis group/septic shock group.Collect general information about patients.Extract serum in patients with in fection related protein(CRP PCT),blood culture(in patients with early onset a nd peak heat samples),urine culture(clean middle urine inspection),sputum cu lture alveolar lavage(training),cytokine detection(IL-1??IL-2?IL-4?IL-5?IL-6?IL-8?IL-10?IL-12?IL-17?TNF-??IFN-??IFN-?),respiratory pathogen s related to genetic testing or acer for detection,blood routine,liver and kidne y function,Coagulation function,blood gas analysis.Besides,the score of Glasgo w coma scale,SOFA score,APACHE ? score,etc.,these datas were improve d to collect and analyze.We used SPSS 19.0 statistical software package for stat istical analysis,basic description of the enumeration data using examples and c omposition ratio representation,the measurement data of normal distribution wer e expressed as mean ± standard deviation,measurement data of skewed distribut ion are expressed by quartiles,the chi-square test was used to compare the enu meration data,two independent sample t test was used to compare the measure ment data of normal distribution between two groups,the rank sum test of two samples was used to compare the measurement data of skewed distribution be tween the two groups,and P<0.05 indicated that the difference was statistica lly significant.Results:1.After the chi-square test,gram negative bacilli and gram-positive bacilli gro up gender differences have no statistical significance(P=0.586),after two ind ependent sample t-test,gram-negative bacilli and gram-positive bacilli age differ ence was not statistically significant(P=0.464),after two sample rank and in spection group of gram-negative bacillus and gram positive bacillus group of I L-6,IL 8,IL-10,IL-17 difference was statistically significant(P<0.05),Among them,IL-6,IL-8 and IL-10 in the gram-negative group were significant ly higher than that in the gram-positive group.2.After the chi-square test,blood-borne infection group and non blood-borne infection sex differences in no statistical significance(P=0.054),after two independent sample t-test,blood-borne infection group and non blood-borne infection age difference has no statistical significance(P=0.054),after two sample rank and inspection blood-borne infection group and non blood-borne infections IL-6,IL-10,IL-17 difference was statistically significant(P<0.05).The level of il-6 and IL10 in patients in the blood-borne infection group was significantly higher than that in the non-blood-borne infection group.3.After the chi-square test,sepsis and septic shock group gender differences have no statistical significance(P=0.815),after two independent sample t-test,sepsis and septic shock group age difference has no statistical significance(P=0.694),after two sample rank and inspection,sepsis group and septic shock group there was no statistically significant difference except the IL-17(P=0.358),and the rest of the index difference had statistical significance(P<0.05).Cytokine elevations were more acute in patients with septic shock.Conclusions:1.Cytokines are increased to different degrees in infected patients.2.Cytokines may have some application value in differentiating gram-negative bacteria from gram-positive bacteria infection,among which IL-6,IL-8 and IL-10 are higher in patients with gram-negative bacteria infection.3.Cytokines IL-6 and IL-10 may have some diagnostic value in differentiating between blood-borne and non-blood-borne infections.Its concentration in periph eral blood of patients with blood-borne infection was significantly higher than t hat of patients with non-blood-borne infection.4.A large number of cytokines are increased in patients with sepsis and septic shock,and the level of cytokines in patients with septic shock is more severe than that in patients with sepsis,which can be up to a thousand times that o f normal human body.It suggests that cytokines may have some application val ue in the stratification of severity of sepsis.