简化免疫失调指数（IL-6/LY）作为脓毒症患者28天住院死亡率和MODS的可靠预测因子

IF 4.2 2区医学 Q2 IMMUNOLOGY

Journal of Inflammation Research Pub Date : 2025-05-28 eCollection Date: 2025-01-01 DOI:10.2147/JIR.S521684

Meili Liu, Tao You, Shifeng Li, Yan Hao, Zhiyang Wang, Fang Huang, Jun Wang

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引用次数: 0

摘要

目的：评价新近简化的免疫失调指标白细胞介素-6与淋巴细胞比值（IL-6/LY）在脓毒症患者预后中的意义。方法：本研究是一项回顾性队列研究，纳入2017年3月至2023年1月在苏州大学第一附属医院重症监护室连续诊断为脓毒症的患者，这些患者符合纳入标准。采用多变量COX和logistic回归模型估计IL-6/LY与28天住院死亡率或多器官功能障碍综合征（MODS）之间的关系。限制三次样条和生存分析显示IL-6/LY与死亡率之间的非线性相关。采用受试者工作特征（ROC）曲线分析IL-6/LY的预后价值。采用Kaplan-Meier法进行分析。结果：该研究包括301名参与者，根据截断值326.04分为低IL-6/LY和高IL-6/LY两组。在多变量分析中，高IL-6/LY与住院28天死亡率（风险比[HR]: 8.01, 95%可信区间[CI] 4.67-13.74, P < 0.001）和MODS（优势比[OR] 3.44, 95% CI 1.85-6.38, P < 0.001）独立相关。IL-6/LY预测死亡和MODS的曲线下面积分别为0.893 （95% CI, 0.855 ~ 0.931）和0.743 （95% CI, 0.688 ~ 0.798）。Kaplan-Meier分析显示，高IL-6/LY组的死亡风险显著升高（≥326.04）（log-rank P < 0.001）。结论：IL-6/LY与脓毒症患者住院28天死亡率和MODS风险显著相关，可作为风险分层的潜在预后指标，早期发现高危患者，及时干预，制定个性化治疗策略，优化患者预后。

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A Simplified Immune-Dysregulation Index (IL-6/LY) as a Robust Predictor of 28-Day In-Hospital Mortality and MODS in Patients with Sepsis.

Objective: To evaluate the prognosis significance of a newly simplified immune-dysregulation index, interleukin-6-to-lymphocyte ratio (IL-6/LY), in individuals diagnosed with sepsis.

Methods: This was a retrospective cohort study enrolling consecutive patients diagnosed with sepsis who qualified the inclusion criteria and were admitted to the intensive care unit of the First Affiliated Hospital of Soochow University between March 2017 and January 2023. Multivariate COX and logistic regression models were used to estimate the association between IL-6/LY and 28-day in-hospital mortality or multiple organ dysfunction syndrome (MODS). Restricted cubic splines and survival analysis were used to show a nonlinear correlation between IL-6/LY and mortality. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the prognostic value of IL-6/LY. was performed using the Kaplan‒Meier method.

Results: The study encompassed 301 participants, categorized into two groups-those with low IL-6/LY and high IL-6/LY-determined by the cutoff value of 326.04. On multivariate analyses, a high IL-6/LY was independently associated with 28-day in-hospital mortality (hazard ratio [HR]: 8.01, 95% confidence interval [CI] 4.67-13.74, P < 0.001) and MODS (odds ratio [OR] 3.44, 95% CI 1.85‒6.38, P < 0.001). The area under the curve of IL-6/LY for predicting death and MODS were 0.893 (95% CI, 0.855-0.931) and 0.743 (95% CI, 0.688-0.798), respectively. The Kaplan‒Meier analysis showed a significantly higher risk of mortality in the high IL-6/LY group (≥ 326.04) (log-rank P < 0.001).

Conclusion: The IL-6/LY is significantly associated with the risk of 28-day in-hospital mortality and MODS in patients with sepsis, making it a potential prognostic marker for risk stratification, which enables early identification of high-risk patients, timely interventions, and personalized treatment strategies to optimize patient outcomes.

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来源期刊

Journal of Inflammation Research Immunology and Microbiology-Immunology

CiteScore

6.10

自引率

2.20%

发文量

658

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed, open access, online journal that welcomes laboratory and clinical findings on the molecular basis, cell biology and pharmacology of inflammation.