不同程度烧伤患者血清ICAM-1、IL-10、TNF-α变化及预后危险因素分析OACSTPCD

Objective To analyze the changes of serum intercellular adhesion molecule-1(ICAM-1),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)levels and prognotic risk factors in patients with different degrees of burn.Methods In total,130 burn patients treated from September 2019 to March 2022 were selected as the observation group,and 60 healthy people during the same period were selected as the control group.The levels of serum ICAM-1,IL-10 and TNF-α were compared between the observation group and the control group at 3 and 7 d after admission,and the levels of serum ICAM-1,IL-10 and TNF-α in patients with different degrees of burn were compared.According to the prognosis,the observa-tion group was subdivided into survival subgroup and mortality subgroup.The predictive value of serum ICAM-1,IL-10 and TNF-α for the prognosis of burn patients was evaluated by receiver operating characteristic(ROC)curve.Multivariate Logistic regression analysis was used to analyze the prognostic factors of burn patients.Results The levels of serum ICAM-1,IL-10 and TNF-α in the observation group were significantly higher than those in the control group at 3 and 7 d after admission,and the levels of serum ICAM-1,IL-10 and TNF-α were significantly different at 3 and 7 d after admission(P＜0.05).The levels of serum ICAM-1,IL-10 and TNF-α in moderate group were significantly lower than those in severe group,which were signifi-cantly lower in severe group than in extremely severe group(P＜0.05).The levels of serum ICAM-1,IL-10 and TNF-α in moderate group were decreased after admission,while those in severe group and extremely severe group were increased(P＜0.05).ROC curve results showed that the area under the ROC curve of ICAM-1,IL-10 and TNF-α in combination(0.826)in predicting prognosis of burn patients was higher than that of ICAM-1,IL-10 and TNF-αin prediction alone(0.771,0.783,0.743)(P＜0.05).Multivariate Logistic regression analysis showed that lactic acid for the first time,lactic acid at 48 h after admission,mechanical ventilation,and serum ICAM-1,IL-10 and TNF-α at 3 and 7 d after admission were the risk factors for the prognosis of burn patients(P＜0.05,P＜0.01).Conclusion Serum ICAM-1,IL-10 and TNF-α have significant differ-ences in patients with different degrees of burn,and the combined detection of the three has high application value in evalua-ting the prognosis of burn patients.In addition,lactic acid for the first time,lactic acid at 48 h after admission,mechanical ventilation and serum ICAM-1,IL-10 and TNF-α at 3 and 7 d after admission were risk factors affecting the prognosis of burn patients.