关键词: 白介素-4, 急性生理与慢性健康评分, 耐碳青霉烯鲍曼不动杆菌, 预后评估, 联合检测

Abstract: Objective To analyze the prognostic value of interleukin-4 (IL-4) combined withacute physiology and chronic health evaluation ( APACHE Ⅱ ) in the infection of carbapenem-resistant Acinetobacter baumannii ( CRAB). Methods A total of 143 patients with CRAB infectiontreated in Affiliated Hospital of Guangdong Medical University from November 2021 to October 2023were set as the study group, and 49 patients with carbapenem-sensitive Acinetobacter baumannii infection treated in the same period were taken as the control group. According to the clinical outcome of the patients in the study group, they were divided into 2 groups: death group (n = 46) and survival group (n = 97), and the differences of IL-4 and APACHE Ⅱ scores between the study groupand the control group, as well as the death group and the survival group were compared. Pearson correlation analysis was used to calculate the correlation between serum IL-4 level and APACHE Ⅱ score in patients with CRAB infection. Receiver operating characteristic curves (ROC) was used to evaluate the application value of IL-4, APACHE Ⅱ score and joint diagnosis in predicting the adverse clinical outcome of patients with CRAB infection. Results The level of IL-4 and the APACHEⅡ score in the death group were significantly higher than those in the survival group (P < 0. 05).The results of Pearson correlation analysis showed that the two indexes (the level of IL-4 and the APACHE Ⅱ score) had obvious positive correlation ( r = 0. 093, P < 0. 001) . The AUC of serumIL-4, APACHE Ⅱ score and the combined index in evaluating the prognosis of patients with CRABinfection were 0. 712 (95 % CI = 0. 606-0. 817, P < 0. 001), 0. 849 (95 % CI = 0. 763-0. 936, P < 0. 001) and 0. 956 (95 % CI = 0. 927-0. 985, P < 0. 001), respectively. Conclusion Theserum IL-4 and APACHE Ⅱ scores of CRAB patients with poor prognosis are significantly higher than those of survival patients. The combination of serum IL-4 and APACHE Ⅱ scores can be used in the prognosis evaluation of such patients, which is helpful to provide reference for their clinical treatment.

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