| Objective:To study the evaluation value of the ratio of Interleukin-6 to Interleukin-10 for assessment of disease severity and prognosis in patients with sepsis.Methods:Retrospective analysis 79 patients with sepsis were treated in the Affiliated Hospital of North Sichuan Medical College from July 2020 to October 2021,divided into sepsis non-shock group(49 cases)and septic shock group(30 cases)according to whether patients had suffered septic shock or not,recorded the results of patients’ blood tests at the time of admission,counted patients’ general condition,length of hospitalization,length of ICU stay,duration of invasive mechanical ventilation,and combined organ damage.Calculating mortality,IL-6/IL-10 ratio,SOFA score,and APACHE II score.Logistic regression analysis of independent risk factors for septic shock.The patients were divided into the death group(28 cases)and the survival group(51 cases)according to the outcome of 28d.Using chi-square test,rank-sum test,and t-test to compare the difference between two groups.Cox regression analysis of independent risk factors for 28d death in patients with sepsis,plotting of subject working characteristic curves ROC curves,and calculation of area under the curve AUC to assess the sensitivity and specificity of indicators to predict the prognostic risk of 28d death in septic patients.Kaplan-Meier survival curve chart analyzes the relationship between IL-6/IL-10 and 28d mortality in high and low groups.The IL-6/IL-10 ratio was divided into four intervals by quartile method and compared the mortality rates of the four intervals.Results:1.APACHE II score,SOFA score,white blood cell count,PCT,IL-6,IL-10,and lactate were lower in the sepsis non-shock group than in the septic shock group,and albumin was lower in the septic shock group than in the sepsis non-shock group,and the proportion of complications of cardiac,pulmonary,hepatic,and coagulation disorders,length of ICU stay,duration of invasive mechanical ventilation,and intubation rate were all lower in the sepsis non-shock group than in the septic shock group.The differences were statistically significant(P<0.05),and the remaining indicators were not statistically significantly different(P>0.05).2.In the death group compared with the survival group,there were statistically significant differences in previous COPD history,site of infection,concurrent cardiac,pulmonary,hepatic,coagulation impairment,length of hospitalization,length of ICU stay,duration of invasive mechanical ventilation,intubation rate,APACHE Ⅱ score,SOFA score,white blood cell count,IL-6,IL-10,IL-6/IL-10 ratio,and lactate(P<0.05).The death group had a shorter hospital stay,longer ICU stay and,and higher APACHE Ⅱscore,SOFA score,white blood cell count,IL-6,IL-10,IL-6/IL-10 ratio,and lactate compared with the surviving group.3.By Logistic regression analysis,SOFA score and lactate were independent risk factors for septic shock.APACHE Ⅱ score and length of ICU stay were risk factors for 28-day death in septic patients.4.The ROC curve based on the 28-day clinical outcome of the patient showed that the AUC of IL-6/IL-10 ratio,Lactic acid,APACHE Ⅱ score,SOFA score,and PCT was 0.635[95%CI(0.498,0.772)P<0.05],0.654[95%CI(0.528,0.781)P<0.05],0.864[95%CI(0.786,0.943)P<0.05],0.840[95%CI(0.754,0.926)P<0.05],0.840[95%CI(0.754,0.926)P<0.05],The APACHE Ⅱ score had the highest predictive value,and its critical value was 14.5 points,the sensitivity was 96.4%,and the specificity was 74.5%.5.The elevated IL-6/IL-10 group has higher mortality,and a high risk of death in patients with sepsis was predicted when the IL-6/IL-10 ratio was>61.88.Conclusion:1.The IL-6/IL-10 ratio is highly specific and less sensitive in assessing the prognosis of patients with sepsis,and has some clinical value in assessing the risk of death with septic patients.2.SOFA score and lactate are independent risk factors for septic shock.APACHE Ⅱ score and length of ICU stay are associated with 28-d risk of death in septic patients.APACHE Ⅱ score has the highest prognostic value for evaluating septic patients. |
