Abstract:

Objective To analyze the relationship between complement 3（C3）,interleukin 35（IL-35）and the severity and prognosis of sepsis. Methods A total of 80 patients with sepsis were enrolled in this study,including 45 cases of general sepsis（general sepsis group）and 35 cases of severe sepsis（severe sepsis group）. In the severe sepsis group,there were 12 cases of single organ dysfunction（single organ dysfunction subgroup）,16 cases of multiple organ dysfunction syndrome（MODS subgroup）and 7 cases of death（death subgroup）. Clinical data of all patients were collected. Blood routine test [white blood cell（WBC） count,platelet（PLT） count],IgG,IgA,IgM,C3,C4,prothrombin time（PT）,international standardized ratio（INR）,activated partial thromboplastin time（APTT）,fibrinogen（Fib）,alanine aminotransferase（ALT）,total bilirubin（TB）,creatinine（Cr）,creatine kinase isoenzyme MB（CK-MB） and IL-35 were determined within 24 h after patients were transferred to intensive care unit（ICU）. Meanwhie, patients were evaluated by the acute physiology and chronic health evaluation Ⅱ（APACHEⅡ）,and were divided into different groups（APACHEⅡscore≤25 and APACHEⅡ score>25） according to the APACHEⅡ score. Results There were significant differences in the C3 and IL-35 between general sepsis group and severe sepsis group（P<0.05）. There were also significant differences in the C3 and IL-35 between subgroups and general sepsis group（P=0.001,P<0.001）. With the progression of the disease,C3 decreased and IL-35 increased. C3 was positively correlated with PLT and Fib（r=0.32 and 0.52,P<0.001）,and negatively correlated with PT,INR,APTT,ALT,TB,Cr and CK-MB（r=-0.34,-0.38,-0.33,-0.31,-0.27,-0.25 and -0.26,P<0.001）. IL-35 was negatively correlated with PLT and Fib（r=-0.33 and -0.59,P<0.001）,and positively correlated with PT,INR,APTT,ALT,TB,Cr and CK-MB（r=0.41,0.32,0.25,0.42、0.34,0.29 and 0.26,P<0.001）. There were significant differences in the C3 and IL-35 levels between patients with APACHEⅡscore≤25 and those with APACHEⅡ score>25（P<0.05,P<0.001）. C3 was negatively correlated with prognosis（death）（r=-0.63,P<0.05）,and IL-35 was positively correlated with prognosis（death）（r=0.54,P<0.001）. Conclusion C3 and IL-35 are involved in the coagulation disorders and organ damage in sepsis patients. They may be used to evaluate the condition and prognosis of sepsis.

Key words: Interleukin 35, Complement, Sepsis