The Value Of Interleukin-18 In The Diagnosis And Evaluation Of Sepsis

ObjectiveTo investigate the expressing levels of serum IL-18 in patients with sepsis, find the relationships between the levels of IL-18 and the severity, prognosis of sepsis, and then evaluate the value of IL-18 in the severity and prognostic of sepsis.MethodsEighty-nine patients enrolled in ICU of the First Affiliated Hospital of Zhengzhou University from July 2008 to June 2009 period were observed. They were divided into two groups:case group (n=61) and control group (n=28). The vital signs (including body temperature, respiration, pulse, blood pressure), blood routine, liver function, kidney function, blood coagulation were recorded. SOFA score, APACHEâ…¡score and GCS score of patients were calculated. Serum IL-18, C-reactive protein (CRP) and lactate concentration were detected. The relationships between serum IL-18 and severity, prognosis of sepsis were statistical analyzed. The value of IL-18 in evaluation and prognosis in sepsis was assessed.ResultsThere were no statistical difference of vital signs, blood routine, liver function, kidney function, blood coagulation between patients of the two groups. SOFA score of the case group was higher than that of the control group. There were no statistical difference of APACHE II score and GCS score between the two groups.IL-18 (P= 0.008) and CRP (P<0.001) of the case group were higher than that of the control group.MAP, FIB and the pH value in the septic shock group were lower than that of the non-septic shock group (P<0.05). The TBIL, BUN of septic shock group were higher than that of the non-septic shock group (P<0.05). SOFA score (P<0.001), APACHE II score (P=0.004) of septic shock group were higher than that of the non-septic shock group.GCS score was no statistical difference between the two groups. The serum IL-18 levels (P<0.001) and CRP (P=0.018) in the septic shock group was higher than that of the non-septic shock group. The lactic acid was no statistical difference between two groups.The FIB of the survival group was higher than that of the death group (P=0.004), TBIL of the survival group was lower than that of the death group (P=0.001).SOFA score (P<0.001), APACHE II score (P=0.047) of the death group were higher than that of the survival group. GCS of the death group was lower than that of the survival group (P=0.012). IL-18 (P=0.001) and CRP (P=0.001) of the death group were higher than that of the survival group.The lactic acid was no statistical difference between the two groups.The ROC area under the curve of IL-18 in sepsis was 0.912 [95% CI (0.770-1.000), P<0.001], CRP was 0.850 [95% CI (0.753-0.946), P<0.001]. The value of IL-18 was higher than CRP in the diagnosis of sepsis.ConclusionsIL-18 can be used for severity and prognosis of the patients with sepsis. The value of blood IL-18 was not lower than CRP in the diagnosis of sepsis.