The Dynamic Variation Of Il-10 And Its Value In The Early Stage Of Sepsis

ObjectiveTo research the relationship of the level of serum IL-10 in the early stage of sepsis, its dynamic variation in 24h,48h, and 72h, with the severity and prognosis of sepsis. To evaluate the value of the dynamic variation of IL-10 in the severity and mortality risk in the early stage.Method132 patients (sepsis group 96 patients, control group 36 patients) erolled The Intensive Care Unit (ICU) of the First Affiliated Hospital of Zheng Zhou University since Jan,2009 to Feb,2010 were abserved. The patients with sepsis were divided to survival group and death group according to survival to 28-days. The commen data, vital signs (tempreture, respiratory rate, pulse, blood pressure), blood routine, hepatic function, renal function, electrolyte, blood clutting function, arterial blood gas and CRP of all patients were recorded at 24h,48h, and 72h after admission to ICU. The APACHEⅡscore was dynamic observed. Collected 3 ml venous blood and kept plasma which obtained by centrifugating the blood in deep freeze refragetor of negative 70 degree centigrade. The levels of IL-10 were detected by ELISA. The relationship of dynamic variation of IL-10 levels, APACHEⅡscore, and 28-days survival were analyzed. The value of IL-10 in the severity and death risk of sepsis was evaluated.ResultsThe comparison between sepsis group and control group of vital signs, blood routine, hepatc function, renal function, electrolyte, blood clotting function, arterial blood gas, and APACHE II scores in 24h,48h,72h the differences were no statistical significance. The CRP in sepsis group were all higher than control group at 24h,48h, 72h (P all<0.001). The comparison of IL-10 levels groups had significant difference at 24h,48h,72h (P=0.02S, P<0.001, P>0.001, respectively).The comparison between survival group and death group of vital signs, blood routine, hepatc function, renal function, electrolyte, blood clotting function of patients with sepsis at 24h,48h,72h the differences were no statistical significance. The comparison between groups of APACHE II score was significant difference (P=0.004). The APACHE II score shown downtrend in survival group, at 24h,48h, 72h were respectively (22.44±4.75), (22.89±9.05), (15.22±7.61). But shown uptrend in death group, the APACHE II score were respectively (25.33±7.74) (25.07±8.80), (28.13±10.36). The comparison of APACHE II score between 72h and 24h of survival group was significant difference (P=0.048), also between 72h and 48h (P=0.037).The levels of IL-10 in survival group and death group of sepsis at 24h,48h,72h were respectively (100.80±60.06) pg/L, (82.71±8.31) pg/L, (66.92±10.66) pg/L,and (93.23±32.32)pg/L, (152.84±88.29) pg/L, (119.56±37.69) pg/L. The comparison of IL-10 at 24h between groups was no significant difference (P>0.05). But at 48h and 72h were significant difference (P=0.008, P<0.001, respectively). The concentration of CRP in survival group and death group of sepsis at 24h,48h,72h were respectively (67.33±39.12) mg/L, (62.78±41.01)mg/L, (50.35±34.89)mg/L and (173.07±25.84) mg/L, (174.09±28.84)mg/L, (175.58±33.57)mg/L. The comparison of CRP between groups was significant difference (P<0.01).The levels of IL-10 in death group of sepsis at 24h,48h,72h were respectively (93.23±32.32) pg/L, (152.84±88.29)pg/L, (119.56±37.69)pg/L, and the variation between three times had significant difference (F=3.914, P<0.05, by ANOVA). The levels of IL-10 in survival group of sepsis at 24h,48h,72h were respectively (100.80±60.06) pg/L, (82.71±8.31)pg/L, (66.92±10.66)pg/L, and the decrease of IL-10 in 48h and 72h was significant difference (P=0.008, by Games-Howell test).The CRP in death group of sepsis were respectivley (173.07±25.84) mg/L, (174.09±28.84)mg/L, (175.58±33.57)mg/L, there was no significant differenct between them (P=0.973, by ANOVA). The CRP in survival group of sepsis were respectivley 67.33±39.12) mg/L, (62.78±41.01)mg/L, (50.35±34.89)mg/L, the viriation was no significant difference (F=0.471, P=0.630, by ANOVA).The ROC area under the curve of IL-10 in sepsis at 24h,48h,72h were respectively 0.912,0.867,0.962, CRP were respectively 0.915,0.896,0.922, P all 0.001.The analysis of Pearson associativity between IL-10, CRP, APACHEⅡscore at 24h,48h,72h in death group and survival group of sepsis was significant difference (P all<0.01).ConclusionIL-10 may be used for evaluating the severity and death risk of patients with sepsis. The dynamic variation value of IL-10 has more advantage than CRP in the diagnosis and prognosis of death risk of sepsis in 72h.