Variation And Significance Of Serum CRP,PCT,IL-6,IL-10 In Severe Polytrauma Patients

Objective To explore CRP,PCT,IL-6,IL-10 concentration's variation in severe polytrauma patients'serum, as well as prediction for MODS which is secondary to severe polytrauma.Methods CRP,PCT,IL-6,IL-10 concentration's variation in serum were detected by immunoturbidimetry, immunochromatographic method and radioimmunity on the 1st,2nd,3rd,7th day following severe polytrauma. Another 10 healthy cases were tested by the same method as the control group. Patients were followed simultaneously to study the process of MODS.Results(1) There were 16 cases with MODS in this 40 cases'group of severe polytrauma.(2) CPR concentration was obviously higher on 1st,2nd,3rd,7th day post-traumaticly. There was a significant difference between MODS and non-MODS groups(P<0.05). The difference was extremely significant when MODS group and non-MODS group compared with control group respectively(P<0.01).(3) PCT concentration was obviously higher on the 1st day following trauma . The difference was significant when MODS group and non-MODS group compared with control group(P<0.05),and there was no significant difference between MODS group and non-MODS group. PCT concentration was not different on 2nd,3rd,7th day among those groups.(4) IL-6 concentration was obviously higher on 1st,2nd,3rd,7th day. There was a significant difference between MODS group and non-MODS group each time, which was verified by SNK-q test. On 1st and 2nd day , there was a significant difference between non-MODS group and control group, while the difference was not significant on 3rd and 7th day .(5) IL-10 concentration was obviously higher on 1st,2nd,3rd,7th day, and the difference was extremely significant when MODS group and non-MODS group compared with control group respectively(P<0.01).On 1st and 2nd day ,the difference between MODS group and non-MODS group was extremely significant (P<0.01),and it was significant on 3rd day(P<0.05), while no difference on 7th day.(6) Selecting X -S and 25%Q1 of 1st day's CRP as cutoff value, sensitivity for prediction of MODS was calculated as 87.5% and 75%, and specificity was 50% and 87.5%.(7) Selecting X -S and 25%Q1 of 1st day's IL-6 as cutoff value, sensitivity for prediction of MODS was calculated as 81.25% and 75%, and specificity was 33.33% and 41.67%.(8) Selecting X -S and 25%Q1 of 1st day's IL-10 as cutoff value, sensitivity for prediction of MODS was calculated as 81.25% and 75%, and specificity was 33.33% and 62.5%.(9) Selecting 25%Q1 of combined determination of CRP,IL-10 indication as cutoff value, sensitivity for prediction of MODS was calculated as 93.75%, and specificity was 54.17%.Conclusions Compared with normal control group, the serum CRP,PCT,IL-6,IL-10 concentration following severe polytrauma were obviously higher. Among them, CRP,IL-6,IL-10 concentration were significantly different in the earlier period when secondary MODS group compared with non-MODS group, therefore these can be utilized as prediction index for MODS which is secondary to severe polytrauma. Of them, CRP's diagnosis efficiency is higher.