The predictive value of serum IFN-γ and YKL-40 levels for poor prognosis in septic shock patients
Objective To analyze the predictive value of serum interferon-γ(IFN-γ)and cartilage tissue glycoprotein(YKL-40)lev-els on the poor prognosis of septic shock patients.Methods From December 2020 to December 2022,86 patients with Septic shock-who visited Yan'an People's Hospital were prospectively selected,while 80 patients with sepsis and 90 healthy individuals were select-ed as controls,serum IFN-γ and YKL-40 levels were detected by enzyme-linked immunoassay,and serum IFN-γ and YKL-40 levels and clinical data were compared.Serum IFN-γ and YKL-40 levels and their correlation with serum lactate,serum albumin,SOFA score,and APACHE Ⅱ score were analyzed by Pearson method.Cox regression was applied to analyze the influencing factors of mortal-ity in Septic shock patients.ROC was applied to analyze the prognostic value of serum IFN-γ and YKL-40 levels in patients with Septic shock.Results The serum IFN-γ[(30.26±3.85)ng/L,(22.87±3.76)ng/L,(10.75±3.51)ng/L]and YKL-40 levels[(217.58±40.03)μg/L,(178.43±39.25)μg/L,(119.02±38.76)μg/L]in Septic shock patients,pyemia patients,and healthy individuals decreased sequentially,the serum IFN-γ[(28.67±3.84)ng/L vs.(34.38±3.88)ng/L]and YKL-40 levels[(201.76±40.02)μg/L vs.(258.45±40.06)μg/L]in Septic shock patients in the survival group were obviously lower than those in the death group(P<0.05).There was a statistically obvious dif-ference in respiratory rate,serum lactate,serum albumin,SOFA score,and APACHE Ⅱ score between the survival group and the death group(P<0.05).Pearson analysis showed a positive correlation between serum IFN-γ and YKL-40 levels(r=0.41,P<0.001),while serum IFN-γ and YKL-40 levels were positively correlated with serum lactate,SOFA score,APACHE Ⅱ score,and negatively correlated with serum albumin(P<0.05).Cox regression analysis showed that IFN-γ[HR=1.03,95%CI:(1.02,1.04)],YKL-40[HR=1.12,95%CI:(1.06,1.18)],serum lactate[HR=1.21,95%CI:(1.11,1.33)],serum albumin[HR=0.96,95%CI:(0.94,0.98)],SOFA score[HR=1.30,95%CI:(1.18,1.45)],and APACHE Ⅱ score[HR=1.35,95%CI:(1.16,1.58)]were influencing factors for mortality in patients with Septic shock(P<0.001).The AUC of combined detection of IFN-γ and YKL-40 levels in evaluating mortality of sepsis shock patients was obvi-ously higher than that of single detection(ZIFN-γ-combination=2.47,P=0.014;ZYKL-40-combination=3.55,P<0.001),with specificity and sensitivity of 91.67%and 91.94%.Conclusion The serum levels of IFN-γ and YKL-40 in Septic shock patients are high,which are closely related to the prognosis of patients and may serve as potential biomarkers for the prognosis of Septic shock patients.
万方数据
维普
