中西医结合肝病杂志2025，Vol.35Issue(9)：1083-1087,5.DOI:10.3969/j.issn.1005-0264.2025.009.006
白细胞介素33联合降钙素原对慢加急性肝衰竭发生细菌感染中的诊断及预后评估价值
The value of IL-33 combined with PCT in the diagnosis and prognosis evaluation of chronic acute liver failure complicated with bacterial infection
摘要
Abstract
Objective:To investigate the expression levels of serum interleukin33(IL-33)and procalcitonin(PCT)in chronic acute liver failure(ACLF)complicated with bacterial infection and its clinical significance.Methods:A total of 140 patients with ACLF in the Department of Infection,Nanyang Central Hospital,were included and divided into the Infection group(n=51)and non-Infection group(n=89)according to the incidence of bacterial infection.After 30 days of treatment,the patients were defined as the poor prognosis group(n=63)when the disease worsened,and the remaining were defined as the good prognosis group(n=77).The clinical data of all ACLF patients were collected,and the serum IL-33 expression level was detected by ELISA methods.The risk factors of ACLF patients complicated with bacterial infection were analyzed by Logistic regression,and the clinical value of serum PCT and IL-33 levels in the diagnosis of ACLF complicated with bacterial infection was analyzed by ROC curve.Results:There were no significant differences in gender,age,Child-Pugh liver function grade,ALT,AST,TBIL,blood ammonia,creatinine,PT,APTT,and INR levels between non-Infection and Infection group(P>0.05).Compared with the non-Infection group,the levels of WBC,neutrophils,hs-CRP,PCT,IL-33 and MELD scores were significantly increased in the Infection group,while the levels of albumin were significantly decreased,with statistical significance(P<0.05).The Logistic regression analysis showed that increased MELD score(OR=3.561),PCT level(OR=3.778)and IL-33 level(OR=4.665)were independent risk factors for bacterial infection in ACLF patients.In the Infection group,there were 40 cases that had a poor prognosis,and 11 cases with a good prognosis.A total of 23 cases with poor prognosis and 66 cases with good prognosis in the non-Infection group.Compared with the non-Infection group,the proportion of poor prognosis in the Infection group was significantly increased,and the difference was statistically significant(c2=36.227,P<0.001).In the infection group,when compared with good prognosis patients,the levels of serum PCT[(5.56±0.64)ng/mL vs.(4.44±0.52)ng/mL]and IL-33[(111.03±11.48)mg/mL vs.(57.12±8.99)mg/mL]in patients with poor prognosis were significantly higher(P<0.05).In the non-Infection group,when compared with good prognosis patients,the levels of serum PCT[(5.02±0.54)ng/mL vs.(3.89±0.43)ng/mL]and IL-33[(103.34±10.46)mg/mL vs.(45.34±7.98)mg/mL]in patients with poor prognosis were significantly higher(P<0.05).Compared with good prognosis group,the serum levels of PCT[(5.12±0.61)ng/mL vs.(4.18±0.48)ng/mL]and IL-33[(108.57±10.35)mg/mL vs.(50.33±8.56)mg/mL]in the poor prognosis group were significantly increased,the differences were statistically significant(P<0.05).The ROC curve results showed that the AUC of IL-33,PCT and IL-33+PCT in the diagnosis of bacterial infection in ACLF patients were 0.895,0.834,and 0.958,respectively.The diagnostic sensitivity and specificity were more than 85%.Besides,the AUC of IL-33+PCT in the diagnosis of bacterial infection in ACLF patients was significantly higher than IL-33 and PCT,respectively.The diagnostic sensitivity and specificity of IL-33+PCT were superior to IL-33 and PCT,respectively.Conclusion:IL-33 and PCT had a good clinical value in diagnosing bacterial infection and evaluating the incidence of poor prognosis in ACLF patients,and combination of the two indicators had a better clinical application value.关键词
慢加急性肝衰竭/感染/降钙素原/白细胞介素33/标志物Key words
chronic acute liver failure/infection/procalcitonin/interleukin 33/marker分类
医药卫生引用本文复制引用
王浩宇,赵萍,闪海霞,朱喜增..白细胞介素33联合降钙素原对慢加急性肝衰竭发生细菌感染中的诊断及预后评估价值[J].中西医结合肝病杂志,2025,35(9):1083-1087,5.基金项目
河南省医学科技攻关计划项目(No.LHGJ20200905) （No.LHGJ20200905）
