| Objective: To observe the changes in serum interleukin-35(IL-35)in patients with sepsis and its regularity,the association between IL-35 and the infection,and the significance of IL-35 in predicting the prognosis of sepsis,analysis of the application value of IL-35 in the assessment of disease severity and mortality risk,to understand the expression of IL-35 in sepsis are changed,and explore its regularity,to establish the mathematical model of the evaluation of immune function in patients with sepsis,expect a quantitative score and dynamic monitoring of the immune state of sepsis through this model,provide new ideas for the treatment and prognosis of sepsis.Methods:Using prospective research method,Sixty-seven patients with sepsis in intensive care unit(ICU)of Anqing Hospital of Anhui Medical University from June 2015 to February 2017 were enrolled?Thirty healthy volunteers and thirty patients with systemic inflammatory response syndrome(SIRS)were enrolled as healthy control and SIRS groups.The levels of IL-35?procalcitonin(PCT)were determined with enzyme linked immunosorbent assay(ELISA)within 3h after enrollment to ICU,the acute physiology and chronic health evaluation ?(APACHE ?)score was calculated.Then the patients were divided into 28-daydeath group and survival group,and compare the diffrent of the levels of IL-35,then draw the receiver operating characteristic curve and observe the area,sensitivity and specificity?Reliability of IL-35 in diagnosis of sepsis and prognosis of patientsResults:1.The sample included 127 cases,including 67 cases of sepsis patients,30 patients with SIRS but without infection,30 cases of healthy persons,the latter two groups were control group?The sepsis group and SIRS group were 97 cases,divided into survival group(57 cases)and death group(n = 40)according to the survival condition of 28–day?2.Serum IL-35 in sepsis patients was significantly increased compared with that of the control group[ng/L:0.43(0.25):0.24(0.09)? 0.15(0.00),Z=7.862,,P<0.01].,PCT was significantly increased compared with that of the SIRS group[ug/L:6.92(23.44):2.09(1.53),Z=-2.038,P < 0.05],With exacerbation of illness,APACHE ? score,the values of PCT and IL-35 were gradually increased;significant positive correlation between IL-35 with APACHE II and PCT(r=0.587,P<0.001;r=0.691,P<0.001).Besides,from ROC curve,the threshold of IL-35 is 0.30ng/l,the sensitivity of prognosis of death is 0.722,the specificity is 0.759,the area under the ROC curve is 0.735,which prompt IL-35 has good prognostic values to sepsis.3.Sepsis group ? SIRS(no infection)group and control group,they have no significant difference in gender and age(?2=0.260,P=0.878;?2=3.290,P=0.193)?Conclusion: 1.The concentration of IL-35 3h after ICU admission was obviously increased in sepsis patients,and it was positively correlated with PCT,therefore it is valuable in the diagnosis of the sepsis?2.The level of IL-35 was positively correlated with APACHE II,and rise with APACHE II,The levels of IL-35 of Death are significantly increased than alive group,the level of IL-35 has important significance to the prognosis of patients with sepsis. |
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