目的：研究创伤患者血清中白细胞介素33（interleukin 33, IL-33）及其受体可溶性抑癌蛋白2（soluble suppression of tumorigenicity, sST2）水平的变化,并分析两者与患者的创伤严重度及预后间的关系。方法：根据创伤严重度评分(injury severity score, ISS)将67例患者分为轻度创伤组（ISS<20分）和重度创伤组（ISS≥20分）,并选同期30名健康体检者作为健康对照组,分别于创伤后4 h、24 h、72 h、7 d等时间点抽取外周静脉血,应用酶联免疫吸附试验检测血清IL-33和sST2水平,分别比较3组间各时间点的血清IL-33和sST2水平,并比较28 d内患者的病死率;同时比较存活者与死亡者各时间点血清IL-33和sST2水平,应用受试者工作特征（receiver operating characteristic, ROC）曲线选取最佳临界值,评估创伤后血清IL-33和sST2水平预测患者死亡的价值。结果：重度创伤患者创伤后4 h、24 h血清IL-33和sST2水平均高于轻度创伤患者[IL-33,（38.75±28.43） pg/mL比（19.62±9.98） pg/mL,（42.31±37.37） pg/mL比（23.47±13.42） pg/mL,（P<0.05）;sST2,（6.50±3.74） ng/mL比（4.89±2.40） ng/mL,（8.35±2.69） ng/mL比（6.78±3.22） ng/mL,（P<0.05）];死亡患者创伤后24 h至7 d的血清IL-33和sST2水平显著高于存活患者（P<0.01）,创伤后24 h血清IL-33和sST2水平的ROC曲线下面积分别为0.799（P=0.003）和0.751（P=0.012）,最佳临界值分别为15.27 pg/mL和10.99 ng/mL,其预测死亡的灵敏度分别为100%和70%,特异度分别为64%和83%。结论：创伤患者的血清IL-33、sST2水平升高与创伤的程度重及近期预后不良相关,创伤后24 h血清IL-33 和sST2水平可能作为预测创伤患者近期预后的生物标志物。
姚峪岚, 郭恩伟, 任大力, 章冰玉, 杨峰, 陈庆, 刘兴晖, 罗前程, 冯刚
. 创伤患者血清白细胞介素33和可溶性抑癌蛋白2水平与创伤的程度及预后关系[J]. 诊断学理论与实践, 2018
, 17(03)
: 299
-303
.
DOI: 10.16150/j.1671-2870.2018.03.013
Objective: To investigate the correlation of serum interleukin 33（IL-33）and its receptor soluble suppression of tumorigenicity 2(sST2） with injury severity score(ISS) and prognosis in trauma patients. Methods: According to ISS, 67 trauma patients were divided into 2 groups, mild trauma group (ISS<20 points）and severe trauma group（ISS≥20 points）.Serum levels of IL-33, sST2 were measured at 4 h, 24 h, 72 h, 7 d after trauma, and mortality in 28 days were compared between mild trauma group and severe trauma group .Serum levels of IL- 33 and sST2 were compared between the survival and the dead patients. The receiver operating characteristic（ROC） curve was used to determine the cutoff value of indices for predicting the death of patient. Results: The levels of serum IL-33 and sST2 were significantly higher in severe trauma patients than those with mild trauma at 4 h and 24 h [IL-33, （38.75±28.43） pg/mL vs （19.62±9.98） pg/mL, （42.31±37.37） pg/mL vs （23.47±13.42） pg/mL, P<0.05; sST2,（6.50±3.74） ng/mL vs （4.89±2.40） ng/mL, （8.35±2.69） ng/mL vs （6.78±3.22） ng/mL, P<0.05]. The levels of serum IL-33 and sST2 were significantly higher in dead patients than in survival patients during 24 h-7d after trauma (P<0.01). The area under ROC curve of serum IL-33 and sST2 levels at 24 h after trauma were 0.799 (P=0.003) and 0.751( P=0.012), respectively. The optimal cutoff value of serum IL-33 and sST2 levels at 24 h after trauma were 15.27 pg/mL and 10.99 ng/mL respectively, and the sensitivity and specificity for predicting death were 100% and 70%,and 64% and 83%, respectively. Conclusions: Elevated levels of IL-33 and sST2 are associated with poor prognosis in patients with trauma, and serum IL-33 and sST2 at 24 h after trauma could be used as biomarkers for predicting prognosis in patients with trauma.
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