背景:HBP,从嗜中性粒细胞释放的一种新的生物标志物,可能诱导炎症反应并加剧血管通透性,代表脓毒症和脓毒性休克的病理生理特征。然而,尚不确定HBP与其他生物标志物的联合应用是否能增强对脓毒症的诊断能力.我们假设测量包括IL-6·IL-8·HBP,IL-6·IL-8·HBP/ALB和基于HBP的HBP/ALB将提高其诊断效能,甚至优于传统的感染生物标志物。
方法:在2021年7月至2022年6月之间,我们进行了全面的,多中心,观察性队列研究,涵盖黑龙江省六家主要三级医院,中国。根据感染的严重程度将患者分为三类:非败血症,脓毒症,和感染性休克。我们收集了临床和实验室数据,以及感染和炎症生物标志物,用于分析。
结果:共纳入195例患者。在三组中,感染性休克患者(n=75,38.5%)的基线HBP水平明显较高,WBC,Lac,CRP,PCT,IL-6,IL-8和IL-10与非脓毒症患者(n=43,22.0%)和脓毒症患者(n=77,39.5%)相比,所有参数均具有统计学显著性差异(p<0.05)。与SOFA评分和传统的CRP指标相比,PCT,IL-6和IL-8,IL-6·IL-8·HBP和IL-6·IL-8·HBP/ALB的联合指标显着提高了脓毒症和脓毒性休克的诊断性能(AUC分别为0.911和0.902,p<0.001)。
结论:联合检测IL-6·IL-8·HBP和IL-6·IL-8·HBP/ALB可以增强HBP对脓毒症的诊断能力,并为传统生物标志物提供可靠的早期补充指标,用于评估感染患者的疾病严重程度。
BACKGROUND: HBP, a novel biomarker released from neutrophils, may induce inflammatory responses and exacerbate vascular permeability, representing the pathophysiological characteristics of sepsis and septic shock. However, it remains uncertain whether the combination of HBP with other biomarkers yields enhanced diagnostic capacity for sepsis. We hypothesized that measurements included IL-6·IL-8·HBP, IL-6·IL-8·HBP/ALB and HBP/ALB which based on HBP will improve its diagnostic efficacy and even better than the traditional infection biomarkers.
METHODS: Between July 2021 and June 2022, we carried out a comprehensive, multi-center, observational cohort study spanning six leading tertiary hospitals located in Heilongjiang Province, China. Patients were stratified into three categories based on the severity of infection: non-sepsis, sepsis, and septic shock. We collected clinical and laboratory data, along with infection and inflammation biomarkers, for analysis.
RESULTS: A total of 195 patients were enrolled. Among the three groups, patients with septic shock (n = 75, 38.5%) had significantly higher baseline levels of HBP, WBC, Lac, CRP, PCT, IL-6, IL-8, and IL-10 compared to non-sepsis patients (n = 43, 22.0%) and sepsis patients (n = 77, 39.5%), with statistically significant differences (p < 0.05) observed for all parameters. When compared to SOFA score and traditional markers of CRP, PCT, IL-6 and IL-8, the combined indexes of IL-6·IL-8·HBP and IL-6·IL-8·HBP/ALB demonstrated significantly improved diagnostic performance for sepsis and septic shock (AUC 0.911 and 0.902 respectively, p < 0.001).
CONCLUSIONS: The combined measurements of IL-6·IL-8·HBP and IL-6·IL-8·HBP/ALB can augment the diagnostic capacity of HBP for sepsis, and offer reliable early supplementary indicators to traditional biomarkers for assessing disease severity in patients with infection.