Predictive value of interleukin-6 combined with soluble suppression of tumorigenicity 2 for acute respiratory distress syndrome in patients with abdominal sepsis
10.3969/j.issn.1008-9691.2024.05.002
- VernacularTitle:白细胞介素-6与可溶性肿瘤抑制因子2对腹腔感染脓毒症患者合并急性呼吸窘迫综合征的诊断意义
- Author:
Yuyue ZHAO
1
;
Rui QIAN
1
;
Tao LI
1
;
Jun DUAN
1
Author Information
1. 中日友好医院重症医学科,北京 100029
- Publication Type:Journal Article
- Keywords:
Sepsis;
Acute respiratory distress syndrome;
Suppressor of tumorigicity 2;
Interleukin-6
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(5):533-537
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the predictive and diagnostic value of plasma interleukin-6 (IL-6) and soluble suppression of tumorigenicity 2 (sST2) for acute respiratory distress syndrome (ARDS) in patients with abdominal sepsis. Methods A retrospective study method was adopted,clinical data from patients with abdominal sepsis admitted to the department of critical care medicine of China-Japan Friendship Hospital,between January 2022 and December 2023 were collected. These data included gender,age,sST2,IL-6,procalcitonin (PCT),C-reactive protein (CRP),white blood cell count (WBC),neutrophil ratio,hemoglobin (Hb),platelet count (PLT),lactate dehydrogenase (LDH),pH value,arterial partial pressure of oxygen (PaO2),fraction of inspired oxygen (FiO2),arterial partial pressure of carbon dioxide (PaCO2),oxygenation index (PaO2/FiO2),arterial blood lactate acid (Lac),prothrombin time (PT),activated partial thromboplastin time (APTT),D-dimer,acute physiology and chronic health evaluationⅡ(APACHEⅡ) score,and sequential organ failure assessment (SOFA) score. Patients were divided into two groups based on the presence or absence of ARDS. The differences in the above indices between the two groups were analyzed. Spearman correlation analysis was used to examine the relationship between plasma IL-6 and sST2 levels and clinical indicators in the ARDS group. Multivariate Logistic regression was conducted to identify risk factors for ARDS in patients with abdominal sepsis,and receiver operator characteristic curve (ROC curve) were used to assess the predictive value of IL-6 and sST2 for ARDS. Results A total of 89 patients with abdominal sepsis were included,with 41 in the ARDS group and 48 in the non-ARDS group. Compared with the non-ARDS group,the ARDS group showed significantly higher levels of sST2,IL-6,PaCO2,APACHEⅡ score,SOFA score,and FiO2[sST2 (μg/L):733.7 (370.1,1609.1) vs. 86.1 (64.1,129.1),IL-6 (ng/L):1106.79 (405.37,3848.00) vs. 101.00 (44.00,396.00),PaCO2 (mmHg,1 mmHg≈0.133 kPa):40.00 (35.50,45.50) vs. 36.00 (31.85,40.73),APACHEⅡ score:31.7±1.0 vs. 28.6±0.9,SOFA score:10.30±0.50 vs. 8.17±0.70,FiO2:0.600 (0.500,1.000) vs. 0.400 (0.400,0.575),all P<0.05],APTT was significantly prolonged in the ARDS group[s:49.70 (41.95,56.43) vs. 43.30 (39.40,49.60)],pH value,PaO2 and PaO2/FiO2 were significantly decreased[pH value:7.37 (7.30,7.43) vs. 7.41 (7.35,7.47),PaO2 (mmHg):82.00 (68.00,107.00) vs. 119.50 (101.25,154.00),PaO2/FiO2 (mmHg):157.00 (99.10,200.00) vs. 297.56 (228.00,386.00),all P<0.05]. Spearman correlation analysis showed in the sepsis-related ARDS group,plasma IL-6 was positively correlated with PCT,SOFA score,and Lac (r were 0.437,0.470,and 0.374,respectively;P value were 0.005,0.002,and 0.016,respectively),plasma sST2 levels were also positively correlated with PCT,SOFA score,and Lac (r were 0.492,0.454,and 0.441,respectively;P value were 0.009,0.013,and 0.015,respectively). Multivariate Logistic regression analysis indicated that plasma sST2 and IL-6 had diagnostic value for ARDS in patients with abdominal sepsis,with area under the curve (AUC) values of 0.978 and 0.719,respectively,and optimal cut-off values of 246.9 μg/L and 397.8 ng/L,both P<0.05,sensitivities were 86.2％ and 79.3％,and specificities were 100.0％ and 85.0％ for sST2 and IL-6,respectively. Conclusion Plasma sST2 and IL-6 are closely associated with ARDS in patients with abdominal sepsis and have high diagnostic value for identifying ARDS in this population.
