摘要
目的 探究烧伤患者血清细胞间黏附分子-1(ICAM-1)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平变化及对预后的评估价值.方法 选择2019 年6 月—2022 年3 月烧伤科收治的179 例烧伤患者,根据预后情况分为生存组和死亡组,对比2 组患者入院后第1、3、5、7 天血清ICAM-1、IL-10、TNF-α水平.采用Pearson相关性分析烧伤患者血清ICAM-1、IL-10、TNF-α间的相关性,采用受试者工作特征(ROC)曲线评估血清ICAM-1、IL-10、TNF-α对烧伤患者预后的预测价值.结果 179 例烧伤患者根据预后情况分为生存组(n=150)和死亡组(n=29).生存组患者血清ICAM-1、IL-10、TNF-α水平均呈先升高后下降趋势,分别在入院后第 5、3、3 天达到峰值(P＜0.01),而死亡组血清ICAM-1、IL-10、TNF-α水平呈逐渐升高趋势(P＜0.01).2 组间入院后第 1、3、5、7 天血清 ICAM-1、IL-10、TNF-α水平比较差异有统计学意义(P＜0.01);不同时间点血清ICAM-1、IL-10、TNF-α水平比较差异有统计学意义(P＜0.01);组别和时间点之间存在交互作用(P＜0.01).Pearson 相关性分析显示,烧伤患者血清 ICAM-1、IL-10、TNF-α互呈正相关(P＜0.05).ROC曲线分析显示,ICAM-1 预测烧伤患者预后的曲线下面积为0.758,IL-10 预测烧伤患者预后的曲线下面积为0.765,TNF-α预测烧伤患者预后的曲线下面积为 0.775,三者联合预测烧伤患者预后的曲线下面积为0.824.结论 烧伤患者血清ICAM-1、IL-10、TNF-α升高,联合检测对评估烧伤患者预后具有较高的临床应用价值,有利于早期采取干预措施.
Abstract
Objective To investigate the changes of serum intercellular adhesion molecule-1(ICAM-1),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)levels and their combined detection in the prognosis of burn patients.Methods A total of 179 burn patients admitted to the Burn Department from June 2019 to March 2022 were selected and di-vided into survival group and death group according to the prognosis.Serum levels of ICAM-1,IL-10 and TNF-α were com-pared between the two groups at 1,3,5 and 7 d after admission.The correlation between serum ICAM-1,IL-10 and TNF-α in burn patients was analyzed by Pearson correlation,and the predictive value of serum ICAM-1,IL-10 and TNF-α in progno-sis of burn patients was evaluated by receiver operating characteristic(ROC)curve.Results In total,179 burn patients were divided into survival group(n=150)and death group(n=29)according to prognosis.Serum ICAM-1,IL-10 and TNF-α levels in the survival group were firstly increased and then decreased,reaching the peak value on the 5th,3rd and 3rd d after admission,respectively(P＜0.01),while the serum ICAM-1,IL-10 and TNF-α levels in the death group were gradually increased(P＜0.01).The levels of serum ICAM-1,IL-10 and TNF-α were significantly different between the two groups on the 1st,3rd,5th and 7th d after admission(P＜0.01).The levels of ICAM-1,IL-10 and TNF-α in serum at dif-ferent time points were significantly different(P＜0.01),and there was interaction between groups and time points(P＜0.01).Pearson correlation analysis showed a positive correlation among serum ICAM-1,IL-10 and TNF-α in burn patients(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of ICAM-1,IL-10 and TNF-αin predicting the prognosis of burn patients was 0.758,0.765,and 0.775,respectively,whereas AUC of the three in combination in predicting the prognosis of burn patients was 0.824.Conclusion The serum ICAM-1,IL-10 and TNF-α of burn patients are elevated,and the combined detection has high application value in evaluating the prognosis of burn patients in clinical practice,which is conducive to early intervention measures.
基金项目
河北省医学科学研究项目(2022)(20221883)
张家口市科技局重点研发计划(2022)(2221098D)
维普
万方数据