| Objective To investigate the level of serum Intermedin(IMD) in patients with sepsis.Method Prospective study, the clinical data of 71 patients with infection were recruited who were in ICU of the General Hospital of Ningxia Medical University from August 1, 2015 to November 30 th,2015.According to the diagnostic criteria of sepsis at admission, the patients were divided into SIRS group(16 cases), sepsis group(20 cases), severe sepsis group(17 cases) and septic shock group(18 cases), and 17 healthy persons were selected as the control group. All objects were collected venous blood within 24 hours after admission in ICU, detected the serum IMD levels using enzyme-linked immuno sorbent assay(ELISA),and recorded the Acute Physiology and Chronic Health Evaluation score II(APACHE II) and Sequential Organ Failur Assessment(SOFA)score and detected the procalcitonin(PCT) and lactate(Lac) levels of the patients at the first 24 hours in ICU. Spearman correlation analysis method was used to analyze the correlation between IMD and PCT,Lac, APACHE II score and SOFA score the receiver operating characteristic curve(ROC) was used to analyze the value of IMD for assessing the severity of sepsis. Adopted independent-sample t test to evaluate the differences of serum IMD level between survival group and death group.Results With the aggravation of sepsis, the level of serum IMD decreased oppositely. The levels of serum IMD among the health group, SIRS group, sepsis group, severe sepsis group and septic shock group were significant differences(P<0.001), Concentrations of the serum IMD were(1564.0±352.84)pg/ml,(1328.02 ± 392.61) pg/ml,(931.28 ± 338.94) pg/ml,(288.19 ± 195.83) pg/ml and(122.82 ± 111.65) pg/ml separately. With the aggravation of sepsis,PCT,Lac,APACHE II score and SOFA score increased.The levels of them among the SIRS group, sepsis group, severe sepsis group and septic shock group were significant differences(P<0.001).Concentrations of the PCT were(1.66±0.77)ng/L,(5.45±3.36) ng/L,(7.00±3.42) ng/L and(7.78±2.47) ng/L separately. Lac were(1.31±0.61)mmol/L,(3.11±1.26) mmol/L,(4.94±2.52) mmol/L and(6.73±2.69) mmol/L separately. Concentrations of the APACHE II score were(7.44±2.03)score,(12.5±3.94) score,(16.35±4.39) score and(19.50±4.34) score separately. SOFA score were(7.31±2.02)score,(12.95±2.33) score,(16.53±4.81) score and(19.39±4.25) score respectively.Spearman correlation analysis method show that there was a prominent negative correlation between IMD and PCT(r=-0.816,P<0.001), IMD and Lac(r=-0.712,P<0.001),IMD and APACHE II(r=-0.859,P<0.001), IMD and SOFA as well(r=-0.837,P<0.001).The area under the ROC curve( AUC) of IMD was 0.852(P<0.001). When selected 1126.23pg/ml of serum IMD as the cutoff value, sensitivity was 95.0% and specificity was 80.6% to diagnose Sepsis. Independent-sample t test showed that the t value of serum IMD in the survival group and death group was 2.211, P was 0.03( P<0.05).Conclusion IMD is involved in the occurrence and development of sepsis. It is closely related to the severity and the prognosis of sepsis, and probably plays a protective role in the disease. |
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