Clinical Significance Of The Change Of Cytokines And Related Immune Indexes In Critically Ill Patients

Objective:To investigate the predictive value of cytokines, lymphocyte-related immune indexes detected in assessing prognosis of critically ill patients.Methods:Totally 39 critically patients were enrolled for prospective study from January 2015 to August 2015. Ptients were divided into survival group and non-survival group according to the 28-day mortality. Ptients were divided into infected group and non-infected group according to the presence of infection. The level of IL-6, IL-8, IL-10, TNF-a, PCT,hs-CRP, immunoglobulin and lymphocyte subpopulation CD3+T, CD4+T,CD8+T and CD4+T/CD8+T ratio in peripheral blood were examined on the 2nd,5th,8th days in EICU. ROC analyses were performed to evaluate the prognosis value of related immune indexes.Results:There were significant difference in IgA (2d),IgM(2d), CD8+T(2d), IL-10(5d), PCT(8d), IL-6(8d), IL-8(8d), CD4+T(8d) and CD4+T/CD8+T ratio(8d) between Survival group and non-survival group(P<0.05). There were significant difference in IL-6(8d), IL-8(8d) and TNF-a (8d) between infected group and non-infected group(P<0.05). The ROC curve of related immune indexes jointly detected respectively. APACHE II score (AUC 0.90), SOFA score (AUC 0.81),PCT (AUC 0.91), IL-10 (AUC 0.77) and CD8+T (AUC 0.79) for Predicting 28-day mortality.Conclusion:Immunologic function impairment occurs in critically ill paitents, especilly in the non-survival patients. Immunosuppression was apparent in critically ill paitents. Dynamic monitoring related immune indexes in the critically ill patients is of great clinical significance in imunnologic function evalution and determinnation of disease severity.