Early warning and prognostic assessment of urosepsis using white blood cells, procalcitonin, and T helper cell subsets type 1 and 2 cytokine profiles
10.3760/cma.j.cn115455-20250210-00122
- VernacularTitle:血白细胞、降钙素原联合T辅助细胞亚群1型及2型细胞因子谱对尿脓毒血症的早期预警及预后评估研究
- Author:
Jia WANG
1
;
Hui JIN
;
Shuping TONG
Author Information
1. 内蒙古民族大学附属医院医学检验中心，通辽 028000
- Publication Type:Journal Article
- Keywords:
White blood cells;
Urinary sepsis;
Procalcitonin;
T helper cell subsets type 1 and Th2 cytokine profiles;
Early warning
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(11):1000-1007
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the early warning value and prognostic assessment of patients with urosepsis using white blood cells (WBC), procalcitonin (PCT), combined with T helper cell subsets type 1 (Th1) and T helper cell subsets type 2 (Th2) cytokine profiles.Methods:A retrospective selection was made of 97 patients with urosepsis admitted to Inner Mongolia University for Nationalities Affiliated Hospital from January 2019 to June 2023 as the case group. During the same period, 60 patients with simple urinary tract infections were selected as the control group, and 60 patients with simple urinary tract infections transitioning to urosepsis were collected as the transition group. The clinical data and laboratory indexes of the three groups were collected, and the differences of WBC, PCT and Th1/Th2 cytokines profiles were compared. Point-biserial correlation was used for analysis. The subject work curve (ROC) was drawn. The area under the curve (AUC) was used to evaluate the early warning value of WBC, PCT and Th1/Th2 cytokines profiles in patients with urosepsis. The patients in the case group were followed up for 28 d. According to the survival outcome, they were divided into death group and survival group. The differences of WBC, PCT and Th1/Th2 cytokines profiles between the two groups were compared. Point-biserial correlation was used to assess their relationship with prognosis, and ROC curves were plotted to evaluate the predictive value of these indicators for urosepsis prognosis.Results:The levels of WBC, PCT, interleukin-6 (IL-6), IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) in different groups of patients were compared. The case group had higher levels than the transformation group and the control group: (12.02 ± 4.11) × 10 9/L vs. (9.88 ± 3.11) and (6.25 ± 2.21) × 10 9/L, (38.52 ± 12.9) ng/L vs. (25.54 ± 10.12) and (12.53 ± 5.01) ng/L, (60.36 ± 20.62) ng/L vs. (45.21 ± 6.95) and (30.64 ± 10.65) ng/L, (25.62 ± 6.85) ng/L. vs. (22.41 ± 3.62) and (20.41 ± 5.95) ng/L, (5.81 ± 0.85) ng/L vs. (5.21 ± 0.15) and (4.71 ± 0.86) ng/L, (5.01 ± 0.62) ng/L vs. (4.51 ± 0.21) and (3.81 ± 0.54) ng/L, there were statistical differences ( P<0.05). Point-biserial correlation confirmed a positive correlation between these indicators and urosepsis ( r>0, P<0.05). ROC curves showed that WBC, PCT, IL-6, IL-10, IFN-γ, and TNF - α had good predictive value for urosepsis, and several combinations had high predictive value, with AUC values of 0.771, 0.871, 0.823, 0.707, 0.860, 0.753, and 0.939, respectively. WBC, PCT, IL-6 and IFN-γ had good predictive value for the transition from simple urinary tract infection to urosepsis, while IL-10 and TNF-α had lower predictive value. The combined predictive value of the above indicators was the highest, with AUC values of 0.824, 0.861, 0.871, 0.869, 0.623, 0.644 and 0.965, respectively, all of which had certain predictive value. Out of 97 patients, 34 died, with a mortality rate of 35.05% (34/97). The levels of WBC, PCT, IL-6, IL-10, TNF - α, and IFN - γ in the deceased group were significantly higher than those in the survival group: (18.00 ± 6.39) × 10 9/L vs. (13.91 ± 4.51) × 10 9/L, (4.96 ± 2.17) ng/L vs. (3.41 ± 0.62) ng/L, (167.52 ± 10.52) ng/L vs. (158.61 ± 14.50) ng/L, (54.50 ± 9.51) ng/L vs. (48.42 ± 12.62) ng/L, (5.84 ± 1.21) ng/L vs. (5.10 ± 1.48) ng/L, (4.33 ± 1.82) ng/L vs. (3.54 ± 1.12) ng/L, there were statistical differences ( P<0.05). Point-biserial correlation analysis revealed a positive correlation between WBC, PCT, IL-6, IL-10, TNF-α, IFN-γ and prognosis ( r>0, P<0.05). The ROC curve was drawn to show that WBC, IL-6, IL-10, TNF-α and IFN-γ had a relatively low predictive value for the prognosis of patients. PCT and the combination of various indicators had a good predictive value for the prognosis of patients, and the combined predictive value was the highest. The AUCs were 0.675, 0.687, 0.637, 0.637, 0.637, 0.727 and 0.880, respectively. Conclusions:WBC, PCT, IL-6, IL-10, TNF-α and IFN-γ are associated with urosepsis and its prognosis, and the combined predictive value is the highest.
