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Objective To study in patients with sepsis early expression of serum IL-10 levels and the relationship between the 24h, 48h, 72h dynamic change and the severity of sepsis clinical prognosis. Evaluation of the dynamic changes of IL-10 early in the sepsis severity and death risk assessment. Observed 132 cases between January 2009 to February 2010 the First Affiliated Hospital of Zhengzhou University, ICU patients, including 96 cases of sepsis group, the control group 36 cases; divided into 28-day survival in patients with sepsis survival group and death group. Collect patients into ICU after the onset of 24h, 48h, 72h, in general, vital signs (including body temperature, respiration, pulse, blood pressure), blood count, liver function, kidney function, electrolytes, coagulation, blood gas and CRP, APACHE Ⅱ dynamic observation score change and specimens from patients into the ICU after the onset of 24h, 48h, 72h venous 3 ml serum at -70 ℃ low temperature refrigerator after centrifugation, all serum IL-10 concentration detected by ELISA kit. Analysis of the 72h consecutive patients with IL-10 expression levels of dynamic change, the relationship between the APACHE II score of 28-day survival. To evaluate the value of IL-10 in the illness severity of sepsis and death risk assessment. Results sepsis group and the control group, the vital signs, blood count, liver function, kidney function, electrolytes, coagulation, arterial blood gases, the severity of the diseases score, etc. 24 hours after the onset of admission to the ICU, 48h, 72h no statistical significance. Sepsis group compared with the control group 24h, 48h, 72h CRP levels mean high P lt; 0.01 sepsis group, serum IL-10 levels were higher than at the same time, 24h group comparison P = 0.028,48 h 72h group comparison P lt; 0.01, statistically significant. Survival group and the group of death in patients with sepsis: vital signs, blood count, liver function, kidney function, electrolytes, coagulation functions 24h, 48h, 72h, no statistical significance. APACHE Ⅱ score in patients with sepsis survival group 24h, 48h, 72h, respectively (22.44 ± 4.75), (22.89 ± 9.05) (15.22 ± 7.61), a downward trend. APACHE Ⅱ score in patients with sepsis death group 24h, 48h, 72h, respectively (25.33 ± 7.74), (25.07 ± 8.80), (28.13 ± 10.36), an upward trend. 72h two groups APACHE Ⅱ score compared survival group APACHE Ⅱ score lower than the death group was statistically significant (P = -0.004). The survival group 72h compared with 24hAPACHE Ⅱ score was significantly lower (P = 0.048), 72h and 48h APACHE Ⅱ score significantly lower (P = 0.037). Patients with sepsis survival group and the death group 24h, 48h, 72h serum IL-10 levels were (100.80 ± 60.06) pg / L, (82.71 ± 8.31) pg / L, (66.92 ± 10.66) pg / L and (93.23 ± 32.32) pg / L (152.84 ± 88.29) pg / L, (119.56 ± 37.69) pg / L, the two groups 24h when no significantly different (P gt; 0.05), 48h, 72h the death serum IL-10 was significantly higher than the survival group (P = 0.008 and P lt respectively; 0.01). Survival group and death in patients in 24h, 48h, 72h CRP serum levels were (67.33 ± 39.12) mg / L. (62.78 ± 41.01) mg / L. (50.35 ± 34.89) mg / L (173.07 ± 25.84) mg / L, (174.09 ± 28.84) mg / L, (175.58 ± 33.57) mg / L; death group at each time point comparison of the two groups of patients CRP serum levels were significantly higher than the survival group, P lt; 0.01. Death group sepsis patients in 24h, 48h, 72h of changes in serum levels of IL-10 were (93.23 ± 32.32) pg / L. (152.84 ± 88.29) pg / (119.56 ± 37.69) pg / analysis of variance: F = 3.914, P lt; 0.05, 24h, 48h, 72h of changes in serum levels of IL-10 significantly changed. Survival of patients in 24h, 48h, 72h of changes in serum levels of IL-10 (100.80 ± 60.06) pg / L, respectively (82.71 ± 8.31) pg / L, (66.92 ± 10.66) pg / L, Games-Howell test see 48h and 72h of IL-10 levels decrease was statistically significant, P = 0.008. Death group of patients with sepsis 24h, 48h, 72h CRP dynamic change (173.07 ± 25.84) mg / (174.09 ± 28.84) mg / (175.58 ± 33.57) mg / variance analysis: F = 0.027, P = 0.973, not statistically significant. Survival of patients in 24h, 48h, 72h CRP serum levels change were (67.33 ± 39.12) mg / (62.78 ± 41.01) mg / (50.35 ± 34.89) mg / application analysis of variance, F = 0.471, P = 0.630, changes significantly. the sepsis patients 24h, 48h, 72h serum IL-10 risk of death of receiver operating characteristic (ROC) area under the curve were 0.912,0.867,0.962; CRP 24h, 48h, 72h death Risk ROC curve area 0.915,0.896,0.922, P are lt; 0.01. Death group and survival of patients with sepsis group 24h, 48h, 72h of IL-10, CRP, APACHE II score Pearson correlation analysis, P lt; 0.01. Conclusion IL-10 can be used for the assessment of the severity of the disease and the risk of death prognosis in patients with sepsis. 72h dynamic changes of IL-10 in the assessed value of sepsis diagnosis, prognosis and risk of death than CRP.
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