目的分析脓毒症患者血浆白介素(interleukin,IL)-33的变化规律及临床价值。方法选取本院2013年12月至2015年12月住院治疗的脓毒症患者45例为研究对象,根据感染严重程度和器官功能,将其分为一般脓毒症组(15例)、严重脓毒症组(16例)和感染性休克组(14例)。分析三组患者入ICU后不同时间点降钙素原(procalcitonin,PCT)、炎性细胞因子水平和急性生理学与慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分的变化情况。比较三组患者入ICU后3小时的PCT、IL-1β、IL-6、肿瘤坏死因子-α(TNF-α)水平和APACHEⅡ评分及预后。分析IL-33与其他炎性细胞因子及预后之间的关系。结果入ICU后3小时、24小时和5天,脓毒症患者PCT、IL-33、IL-1β、IL-6、TNF-α水平及APACHEⅡ评分均呈下降趋势(P<0.05)。入ICU后3小时,三组患者PCT、IL-33、IL-1β、IL-6、TNF-α水平、APACHEⅡ评分、机械通气时间及ICU住院时间组间比较依次为:一般脓毒症组<严重脓毒症组<感染性休克组(P<0.05)。脓毒症患者入ICU 3小时内,IL-33水平与PCT、TNF-α、IL-1β、IL-6水平及APACHEⅡ评分、机械通气时间、ICU住院时间均呈正相关(P<0.05)。入ICU后3小时、24小时和5天,死亡患者的IL-33水平显著高于同期存活患者(P<0.05)。结论脓毒症的严重程度和血浆IL-33水平具有相关性,IL-33对于脓毒症患者的预后具有一定的预测价值。 Objective To analyze the changes and clinical value of plasma interleukin (IL) -33 in patients with sepsis. Methods Forty-five sepsis patients hospitalized in our hospital from December 2013 to December 2015 were selected as study subjects. According to the severity of infection and organ function, they were divided into general sepsis group (15 cases), severe pus (16 cases) and septic shock group (14 cases). The levels of procalcitonin (PCT), inflammatory cytokines and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score at different time points after ICU were analyzed in the three groups. The levels of PCT, IL-1β, IL-6, tumor necrosis factor-α (TNF-α) and APACHEⅡ scores and prognosis were compared among the three groups at 3 hours after ICU admission. The relationship between IL-33 and other inflammatory cytokines and prognosis was analyzed. Results The levels of PCT, IL-33, IL-1β, IL-6, TNF-α and APACHEⅡ in septic patients all showed a decreasing trend at 3h, 24h and 5d after ICU admission (P <0.05). The levels of PCT, IL-33, IL-1β, IL-6, TNF-α, APACHEⅡscore, duration of mechanical ventilation and length of ICU stay in the three groups were compared as follows: general sepsis group < Severe sepsis group