| Objective: The objective of this study is to investigate the clinical value of the soluble interleukin-7 receptor(sIL-7R)in the diagnosis and assessment of sepsis.Methods:From January 2021 to June 2022,we gathered data from inpatients treated at the resuscitation unit and intensive care unit(ICU)of Beijing Chui Yangliu Hospital and Baoding First Central Hospital.The patients were then divided into two groups according to the sepsis 3.0guidelines: the sepsis group,which comprised both shocked and non-shocked patients(n=80),and the non-sepsis group(n=22).We also collected data from medical examiners during the same period as the control group and categorized them into a healthy group(20 cases)and a chronic disease group(20 cases).We recorded relevant indicators such as sIL-7R and other biomarkers,as well as critical illness scores,for all the groups.Statistical analysis was performed using SPSS23.0 software and the R Programming Language to evaluate the diagnostic and assessment capabilities of sIL-7R.A receiver operating characteristic curve(ROC)was plotted to elaborate the value of sIL-7R for the diagnosis and condition assessment of sepsis.Results:1.The sIL-7R plasma level was 0.5±0.17 ng/ml in the healthy group and0.44±0.19 ng/ml in the chronic disease group(P=0.35),indicating no significant difference between the two groups.2.The sIL-7R level was significantly higher in the sepsis group than in the non-sepsis group and the healthy group(P<0.01)and showed diagnostic value.Based on R Programming Language statistical software analysis,sIL-7R,age,C-reactive protein(CRP),and interleukin 6(IL-6)were identified as important indicators for sepsis diagnosis,with AUCs of 0.759,0.622,0.716,and 0.640,respectively.A diagnostic model constructed based on these four indicators showed better performance than other indicators,with an AUC of0.869.3.On day 5 of sepsis admission,the sIL-7R level was 2.09±0.65ng/ml in the surviving group and 1.07±0.53ng/ml in the death group(P<0.0001),which was statistically significant.The sIL-7R level was found to be significantly correlated with T lymphocytes(CD3+)and lymphocytes(LYM),with R values of 0.55 and 0.47,respectively.4.The combination of sIL-7R and the Acute Physiology and Chronic Recovery Score II(APACHE II)and Sequential Organ Failure Score(SOFA)provided predictive value for sepsis prognosis.The optimal combination of these variables was sIL-7R + SOFA score,which had an AUC of 1.000 according to the ROC curve.5.On day 1,there was no statistically significant difference in sIL-7R plasma levels between the sepsis non-shock group(2.65±1.09)and the shock group(2.47±0.98)(P=0.51).However,on day 5,the sIL-7R levels were significantly different between the two groups(1.91±0.67 versus 1.54±0.69,respectively,with P<0.05.Conclusion: sIL-7 levels were not significantly different between the healthy and chronic disease groups,suggesting that it is not significantly affected by common chronic diseases such as hypertension and diabetes.Therefore,it can serve as a potential biomarker to aid in the diagnosis of sepsis.Moreover,the combination of sIL-7 with age,CRP,and IL-6 can enhance the accuracy of early diagnosis of sepsis.The study also revealed that the sIL-7R levels decreased dramatically on day 5 in the septic death group,and when paired with the SOFA score,it proved to be the most efficient predictor of sepsis regression.Additionally,sIL-7R was found to be positively correlated with CD3+ and LYM,which can help in the assessment of immune function in patients.Nevertheless,for sepsis stratification,the two indicators,the APACHE II and SOFA indicators outperformed other markers.While sIL-7R may not have a significant reference value in early sepsis stratification,it can have some assessment value in sepsis progression stratification. |
