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Sepsis is the infection caused by systemic inflammatory response syndrome (SIRS), and a variety of severe trauma, burns, shock, reperfusion injury and common complication after major surgery, the mortality rate is as high as 30-50%. The mechanism of sepsis is extremely complex, its complex and nonlinear characteristics led to their diagnosis, prediction and treatment of uncertainty. This is the main reason for the high current sepsis mortality. Therefore, the new sepsis biomarker study to explore the sepsis diagnosis, prediction, and evaluation of treatment efficacy to guide the prevention and treatment of sepsis, to reduce the morbidity and mortality has important scientific significance. The subject rat model of sepsis, cecal ligation and puncture (CLP) and observation of the rat CLP serum inflammatory mediators of TNF-α, IL-1β, IL-6, granulocyte - macrophage colony stimulating factor (GM-CSF ), high mobility group box protein 1 (HMGB1) and monocyte chemoattractant protein -1 (MCP-1) and blood urea nitrogen (BUN) and creatinine (Cr), lactate dehydrogenase (LDH), alanine aminotransferase ( ALT), aspartate aminotransferase (AST), creatine kinase (CK) and blood changes, to explore changes in these indicators and their with septic rats prognosis, trying to filter out meaningful indicators to establish the index set, and The sensitivity, specificity, and accuracy of the index set on septic rats prognostic assessment, in order to improve the prognosis of septic rats. The results are as follows: 1. CLP rat model replication: row after CLP rats, 6h begin to die ,12-24h death up to 72 hours mortality was 59%; serum inflammatory mediators TNF-α, IL-1β, IL-6, GM-CSF and HMGB1 levels increased significantly; to the CLP postoperative 12h rats were sacrificed, found multiple organs (heart, liver, lung, brain and kidney) occurred morphological changes. After CLP 72h whether death is divided into survival group and the death group. Survival of rats 12 hours after CLP ALT, AST, HMGB1, IL-6, and MCP-1 levels higher than before surgery (p lt; 0.05 or p lt; 0.01); white blood cell count, platelet count, CK and IL-1β level lower than the preoperative (p lt; 0.05 or p lt; 0.01). Death of rats 12 hours after CLP body temperature, red blood cell count, hematocrit, BUN, ALT, AST, HMGB1, IL6, and MCP1 level higher than before surgery (p lt; 0.05 or p lt; 0.01); white blood cell count, platelet lower than the preoperative count, serum creatine kinase levels (p lt; 0.05 or p lt; 0.01). 3 the death group BUN in the Aristolochia 12 hours after CLP Cr, ALT, LDH, CK, IL-6, and MCP-1 levels higher than the survival group (p lt; 0.05 or p lt; 0.01); platelet count, serum HMGB1 and GM -CSF levels lower than the survival group (p lt; 0.05 or p lt; 0.01). 4.CLP 12 hours after the body temperature and blood urea nitrogen, creatinine, alanine aminotransferase, creatine kinase, IL-6, and MCP-1 levels in rats survival outcome was negatively correlated with platelet count, serum HMGB1 and GM-CSF with rat survival outcome was a positive correlation. 5. Logistic regression was used to determine the value of each index in the prediction of prognosis in sepsis and select the optimal set of indicators, analysis of the sepsis prognosis indicators, found that the blood urea nitrogen, creatinine, IL-6 . GM-CSF into the equation predicts sensitivity (86.2%), specificity (83.3%) and accuracy (84.7%) reached the highest, Based on the following regression equation: Logit P = -8.367 1.124BUN 1.134 Cr 0.003IL6-0.249GM-CSF which P is the ratio of the probability of death and survival, LogitP death and survival probability than the natural logarithm. In summary, this study is a successful replication rat CLP sepsis model based on screening a rat sepsis prognosis indicators, and selecting the optimal index set to establish a predictive model of sepsis prognosis. The prediction model, the septic rats serum BUN, Cr, IL-6 levels, and reduce the level of GM-CSF poor prognosis. The above results for the prognosis and treatment evaluation of clinical sepsis provide new experimental evidence and research ideas.
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