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1、·474·ChineseCriticalCareMedicine,August2002,Vol.14,No18·论著·降钙素原与白介素6的相关性优于传统的炎症指标1121杜 斌,陈德昌,潘家绮,李 毅(1.中国医学科学院中国协和医科大学北京协和医院加强医疗科;2.血液内科,北京 100730) 摘要:目的:确定全身性感染患者的传统炎症指标〔体温、白细胞计数、中性粒细胞比例、中性粒细胞计数、C反应蛋白(CRP)〕及降钙素原(PCT)与白介素6(IL6)水平间的相关关系。方法:共有51例患者入选。临床发生全身性感染或全身
2、性炎症反应综合征(SIRS)后24小时内测定血清PCT、IL6和CRP,同时记录白细胞计数、中性粒细胞比例、中性粒细胞计数和最高体温。结果:PCT与血清IL6水平密切相关。比较受试者工作特征曲线下面积(AUC),PCT对IL6水平(以500ngöL和1000ngöL作为临界值)的预测能力最强(分别为01685和01858),体温(分别为01662和01792)和CRP(分别为01625和01727)的预测能力中等,而白细胞计数、中性粒细胞比例和中性粒细胞计数的预测能力最差。PCT的敏感性、特异性、阳性预期值和阴性预期值
3、也最高。结论:与传统的炎症指标相比,PCT可以更准确地反映促炎症因子的升高情况。关键词:体温;白细胞计数;C反应蛋白;降钙素原;白介素6中图分类号:R363.27;R631 文献标识码:A 文章编号:10030603(2002)080474041Procalcitoninmaybeabetterpredictorofinterleukin6thanconventionalinflammatorymarkersDUBin,121CHENDechang,PANJiaqi,LIYi.1.DepartmentofCriti
4、calCareMedicine;2.DepartmentofHemato2logy,PekingUnionMedicalCollegeHospital,Beijing100730,ChinaAbstract:Objective:Todeterminethecorrelationsandpredictivecapabilityofconventionalinflammatorymarkers〔bodytemperature,whitebloodcell(WBC)count,percentageofneutrophils,
5、absoluteneutrophilcount(ANC),Creactiveprotein(CRP)〕andprocalcitonin(PCT)withelevatedlevelsofinterleukin6(IL6)insepticpatients.Methods:Fiftyonepatientswereenrolledinthestudy.SerumconcentrationsofPCT,IL6andCRPweredeterminedwithin24hoursafterclinicalonsetofsepsisor
6、systemicinflammatoryresponsesyndrome.WBCcount,percentageofneutrophils,andANC,aswellasmaximalbodytemperaturewerealsorecorded.Results:PCTwassignificantlycorrelatedwithserumIL6levels.Basedonareaundercurveofthereceiveroperatingcharacteristicscurves,thepredictivecapa
7、bilitywashighestforPCT(01685,forIL6,500ngöL;and01858,forIL6,1000ngöL),moderateforbodytemperature(01662and01792,respectively)andCRP(01625and01727,respectively),andlowestforWBCcount,percentageofneutrophilsandANC.Sensitivity,specificity,positiveandnegativepredictiv
8、evaluesallfollowedthesamepatternofbeinghighestforPCT.Conclusions:Comparedwithconventionalinflammatorymarkers,PCTmayreflectmorereliablytheelevatedlevelsofproinflammato
