The value of serum interleukin-18 and 10 in the evaluation of severity and prognosis in the early stage of sepsis

Abstract

To observe the dynamic changes in levels of serum interleukins (IL-18, IL-10) in the early stage of sepsis, and to appraise their values in the evaluation of severity and prognosis of sepsis. Prospective randomized controlled study was conducted. Thirty-eight patients with sepsis who stayed longer than 72 hours in intensive care unit (ICU) from December 2009 to August 2010 were enrolled as sepsis group. At the same time, 20 patients without sepsis served as control group. The patients were classified as survival (n=12) or death group (n=26) according to 28-day survival. The clinical laboratory examination data were recorded at 24, 48, 72 hours after admission to the ICU, and venous blood was obtained at the same time. The IL-18, IL-10 levels were determined by enzyme-linked immunosorbent assay (ELISA). The vital signs, blood routine, liver function, renal function, coagulation function, arterial blood gas, and electrolyte showed no significant difference between sepsis group and control group 24, 48, 72 hours after admission, the levels of IL-18 were lowered, IL-10 elevated, the IL-18/IL-10 ratio was lowered in the sepsis group, and all of them were higher than control group at each time point. The levels of IL-18, IL-10 in death group of patients with sepsis were all higher than those of survival group at 24, 48, and 72 hours [ IL-18 (ng/L): 108.36±18.54 vs. 91.66±21.49, 92.13±28.92 vs. 54.16±31.76, 91.78±17.33 vs. 76.04±22.09; IL-10 (ng/L): 99.42±12.10 vs. 77.20±9.47, 103.39±17.24 vs. 67.88±18.90, 118.99±11.20 vs. 99.20±12.46, P<0.05 or P<0.01]. IL-18/IL-10 ratios were all lowered in both non-survivors and survivors with sepsis at 24, 48, 72 hours, while the differences were not statistically significant (1.09±0.19 vs. 1.20±0.32, 0.92±0.18 vs. 0.98±0.29, 0.78±0.15 vs. 0.77±0.23, all P>0.05). The levels of serum IL-18, IL-10 were all elevated in the early stage of patients with sepsis, and in non-survivors they were higher than those of survivors. With the progress of the illness, IL-18 showed a lowering tendency, while IL-10 showed an elevation. The levels of serum IL-18 and IL-10 may be valuable in evaluating the severity of sepsis and prognosis of patients with sepsis.