| Objectives:In order to find the clinical index of sepsis by monitoring the dynamic changes of serum FN, IL-6, TNF- and CRP in patients with sepsis.Method:Serum samples were collected from 50 patients as infection group who were admitted in Fujian Medical University Union Hospital intensive care unit(ICU), 12 patients with sepsis, 38 patients with sepsis and multiple organ dysfunction. Collect serum samples of multiple time point(time interval is more than 24 hours) and daily SOFA score until patients discharge or died. The patients were divided into two group according to the trend of SOFA during hospital.The trend of SOFA score to increase as deterioration group,the other was remission group which trend to decline.50 healthy people were collected as controll. Enzyme linked immunosorbent assay(ELISA) was used to detect the levels of serum FN, CRP, IL-6 and TNF-alpha. According to the SOFA score catogorie the index were divided into four group: 1-6 group, 7-12 group, 13-18 group and 19-24 group.Abnormal distribution data are represented by quartile.Measures of Dispersion beside the group were represented by quartile deviation, Mann whiteney U test to define differences besides the group. Combining with SOFA score catogories to evaluate the dynamic changes of FN, CRP, IL-6, TNF alpha in patients with sepsis and the value of biomarkers in condition assessment.Results:The serum CRP level in infection group(119.9±135 g/ml) was significantly higher than controll group(3.3±3.8g/ml)(P<0.0001). The level in deterioration group(150±151.1 g/ml) was higher than remission group(101±117.8g/ml)(P<0.0001). Serum CRP level in 68.4% deterioration group increased, 82.1% remission group showed downward trend. The concentration between 13-18 group and 19-24 group showed no significant difference. Serum CRP and SOFA score is positively correlated, the quartile deviation besides four group is during 121.8 to 182.1ug/ml, but the dilution ratio is 600000,which showed high sensitivity.1. The IL-6 concentration in infection group(468.0±902.3pg/ml) was higher than the controll group(12.3±6.4pg/ml). The level of deterioration(678±1116.7pg/ml) was higher than the remission group(337±694.5pg/ml)(P<0.0001). The trend of TNF alpha in 66.7% deterioration group is decreased comparing to the 42.8% remission group declining. There was no significant difference between 13-18 group and 19-24 group. The serum IL-6 level was positively correlated with SOFA score. the quartile deviation besides four group is during 38.3 to 2763.9pg/ml. The detection rate of TNF alpha is low(60%), the serum level of TNF alpha in infection group(35.3 ±179.7 ? g / ml) was higher than control group(0.2±1.1?g/ ml)(P < 0.001). There was a significant difference in deterioration group(9.85±54.1 g/ml) and control group(57.6±230.8g/ml)(P=0.005).concentraion in 29.4% deterioration group showed a tendency to increase,26.9%% remission group showed declining.There was no significant difference between 6-12 group and 13-18 group. Patients with sepsis and multiple organ failure(51.7 ±213.5pg/ml) was higher than sepsis(4.2±30.3pg/ml)(P<0.05).The quartile deviation is during 0 to 13.8ug/ml. The serum FN of infection group(187.8±139.2?g/ ml)was significantly lower than that of control group(427.2±115.5 ? g / ml)(P<0.0001), the level of FN in deterioration group(16.68 + 107.9 ? g / ml) was lower compare to remission group(207.1±160.0 ? g / ml)(P < 0.0001). The serum FN concentration of the 90% deterioration group showed a tendency to increase compare to the 82.1%remission group showed a trend of recovery. There is a significant difference between these corresponding SOFA catogories.significant difference, the quartile deviation besides four group is during 106.5 to 168.2ug/ml.Conclusion:The serum FN, CRP, IL-6, TNF- alpha can assess the severity of sepsis, the value of FN in sepsis assessment is better than CRP, IL-6, TNF-alpha. |
PDF Full Text Request