Relationship between the expression level of interleukin-37 and immune function and clinical prognosis in patients with sepsis

LIN Fang-chong; FU Chao; LI Fen

doi:10.16048/j.issn.2095-5561.2023.06.02

Abstract：Objective To observe the expression level of interleukin-37(IL-37)in patients with sepsis,and analyze its relationship with immune function and clinical prognosis.Methods A total of 138 patients with sepsis admitted to the Second Affiliated Hospital of Hainan Medical College from January 2020 to January 2023 were selected and divided into septic shock group(n =56)and septic group(n =82),according to whether the patients had septic shock at admission.A total of 50 healthy subjects were selected as the healthy group in the same period.The levels of IL-37 and cellular immunity(CD3+,CD4+,CD8+,CD4+/CD8+)in the three groups were detected.Patients with sepsis were divided into the survival group(n =95)and the death group(n =43)according to whether they died within 28-day after the admission.The clinical datas,acute physiology and chronic health evaluationⅡ(APACHEⅡ)and sepsis-related organ failure assessment(SOFA)score of sepsis patients were recorded.The related factors affecting the prognosis of sepsis pa-tients were analyzed by Logistic regression.Pearson correlation analysis was used to analyze the correlation between IL-37 level and CD3+,CD4+,CD8+,CD4+/CD8+,APACHEⅡ,SOFA scores in the sepsis patients.Receiver operating characteristic(ROC)curve was used to analyze the prognostic value of IL-37 in the sepsis patients.Results The levels of IL-37 and CD8+in the septic shock group and septic group were significantly higher than those in the healthy group,and the levels of CD3+,CD4+and CD4+/CD8+were significantly lower than those in the healthy group(P<0.05).Compared with the sepsis group,the levels of IL-37 and CD8+in the sepsis shock group were significantly higher,and the levels of CD3+,CD4+,CD4+/CD8+were significantly lower(P<0.05).Multi-variate Logistic regression analysis showed that SOFA score,IL-37,CD4+and CD8+were risk factors for death of sepsis patients with-in 28-day after the admission(P<0.05).Pearson correlation analysis showed that the IL-37 level of the sepsis patients was positively correlated with CD8+,APACHEⅡ score and SOFA score(r =0.623,r =0.577,r =0.527,P<0.05),and negatively correlation with CD3+and CD4+(r =-0.651,r =-0.623,P<0.05).The IL-37 level of the sepsis patients was no correlation with CD4+/CD8+(r =-0.147,P =0.086).According to the ROC curve analysis,the sensitivity,specificity and AUC of IL-37 in predicting the progno-sis of sepsis patients were 65.63%,85.79%and 0.793,respectively.Conclusion SOFA score,serum IL-37,CD4+and CD8+are related factors leading to the death of patients with sepsis within 28-day after the admission,and IL-37 has a certain correlation with the changes of immune function and clinical prognosis of patients.