血清炎症メディエーターを用いた敗血症重症度評価の臨床的価値の検討

To evaluate the clinical utility of serum inflammatory mediators in assessing the severity of sepsis and predicting patient prognosis.

A retrospective analysis was conducted on 72 patients diagnosed with sepsis and admitted to the Tianjin Union Medical Center between January 2024 to January 2025, who were stratified into three groups based on disease severity: sepsis(n= 24), severe sepsis(n= 24) and septic shock(n= 24). An additional 24 individuals without sepsis were recruited as the control group. Within 24 hours of hospital admission, serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10) and heparin-binding protein(HBP) were measured, analyzed for their correlation with Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores and their predictive performance for 28-day mortality.

Significant differences were observed in serum TNF-α, IL-10, HBP levels and APACHE-II scores across the four groups(all P< 0.05). All three sepsis subgroups showed significantly elevated levels of TNF-α, IL-10, HBP and higher APACHE-II scores compared with the control group (all P < 0.05). Moreover, a graded increase in these biomarkers and APACHE-II scores was observed across the sepsis subgroups, following the trend: septic shock > severe sepsis > sepsis, with all pairwise comparisons reaching statistical significance(P< 0.05, respectively). When stratified into survival and non-survival groups, the non-survivors exhibited significantly higher levels of TNF-α, IL-10, HBP and APACHE-II scores(P< 0.005, respectively).

Serum levels of TNF-α, IL-10 and HBP are positively correlated with sepsis severity. The combined measurement of these inflammatory mediators can provide a robust and objective approach for evaluating disease severity and predicting prognosis in patients with sepsis.