摘要
Abstract
Objective To explore the value of procalcitonin (PCT) and interleukin-6 (IL-6) in the prognostic evaluation of the elderly patients with complicated intra-abdominal infections (CIAI).Methods A retrospective analysis was made to the clinical data of the cases,aged ≥60 years,with CIAI in ICU,the 1st People's Hospital affiliated to Shanghai Jiao Tong University during the period from Jan.,2013 to Sept.,2016;the cases were divided into 2 groups according to the prognosis:survival group and death group;observation was made to the sex,age,main diagnosis and hospitalization days;the scores of APACHE Iand SOFA,PCT,IL-6,C-reactive protein (CPR),endotoxin,white blood cell count,neutrophil percentage and abdominal pathogen culture result within 24 hours after admission were studied.Results In total,67 elderly patients with CIAI were enrolled;the average of hospitalization duration was 11 days (8,18),the death rate was 43.30 ％;PCT and IL-6 within 24 hours after admission were positively correlated to the scores of APACH II and SOFA;the scores of APACH H and SOFA,the levels of PCT and IL-6 in death group were higher than those in survival group (P＜ 0.05);the hospitalization duration of the cases in death group was shorter than that of the cases in survival group (P＜0.05);the white blood cell count and neutrophil percentage in death group were lower than those in survival group (P＜0.05);there existed no statistical difference in the levels of endotoxin and CRP between the 2 groups (P＞0.05);the major pathogens in death group were gram-negative bacilli (37％) and fungi (30％);the areas under ROC curve for PCT and IL-6 were (0.817 ±0.082) and (0.817 ±0.081) respectively,and the cutoff value of PCT was 84.985 ng/mL and that of IL-6 was 4 675 pg/mL.Conclusions PCT and IL-6 may be of certain guiding role in the assessment of the severity of CIAI in elderly patients and in the prognosis evaluation,and may help clinicians to identify high-risk groups earlier.关键词
降钙素原/白介素-6/APACH Ⅱ评分/腹腔感染/老年患者Key words
procalcitonin (PCT)/interleukin-6 (IL-6)/APACHE II score/intra-abdominal infection/elderly patient
