目前危重患者器官损害的预警模型存在一定的局限性。基于病理机制，利用细胞因子谱建立危重儿童器官损伤预警系统尚未探索。本研究旨在探讨细胞因子对危重患者的预测价值。2018年8月22日至2023年4月28日期间，苏州大学儿童医院共纳入200例危重儿科患者和49例普通患者。回顾性收集并分析临床信息。通过流式细胞术检测这些患者的细胞因子谱。绘制受试者工作特征（ROC）曲线以确定细胞因子与器官损伤之间的关系。危重患者与普通患者的性别、年龄、基础疾病差异无统计学意义。白介素（IL）-6（P<0.001）、IL-10（P<0.001）、IL-17A（P=0.001）、肿瘤坏死因子-α（TNF-α）（P=0.02）和干扰素-γ危重患者(IFN-γ)水平(P=0.02)显着高于普通患者。结果显示，重症患者急性胃肠损伤（AGI）和急性肾损伤（AKI）的发生率分别为39%和23.5%。此外，还有4%和3.5%的患者出现心脏骤停和急性活伤。与没有这些器官损伤的患者相比，这些急性肝损伤患者的 IFN-γ 水平升高，但与没有 AGI 的患者相比，IFN-γ 水平降低。与没有 AKI 的患者相比，患有 AKI 的患者的 IL-10 显着增加。与没有急性肝衰竭（ALF）的患者相比，急性肝衰竭（ALF）患者的IL-2、IL-4、IL-6、IL-10和IL-17A升高，但TNF-α降低。与非心脏骤停患者相比，心脏骤停患者的IL-2、IL-4、IL-6和IL-10显着升高。当IL-10高于279.45 pg/mL时，预测心脏骤停的敏感性和特异性分别为0.875和0.927。而IL-6（超过1,425.6 pg/mL）的敏感性和特异性分别为0.625和0.844。然而，没有观察到 IL-6 和 IL-10 在预测心脏骤停方面的协同作用。此外，IL-17A（超过21.6 pg/mL）是ALF发生率的良好预测因子（敏感性=0.714，特异性=0.876）。有器官损伤和无器官损伤的危重患者的细胞因子谱存在差异。 IL-6 和 IL-10 水平是危重患者心脏骤停的良好预测因子。此外，较高的 IL-17A 可以预测危重患者 ALF 的发生率。2024 转化儿科。版权所有。

The current early warning model for organ damage in critically ill patients has certain limitations. Based on the pathological mechanism, the establishment of an early warning system for organ damage in critically ill children using cytokines profile has not been explored. The aim of this study is to explore the predicting value of cytokines in critically ill patients.There were 200 critically pediatric patients and 49 general patients between August 22, 2018 and April 28, 2023 from Children's Hospital of Soochow University enrolled in this study. The clinical information was retrospectively collected and analyzed. The cytokine profiles of these patients were detected by flow cytometry. Receiver operating characteristic (ROC) curves were plotted to determine the association between the cytokines and organ injury.There were no statistically significant differences in gender, age and underlying disease between critically ill patients and general patients. The interleukin (IL)-6 (P<0.001), IL-10 (P<0.001), IL-17A (P=0.001), tumor necrosis factor-α (TNF-α) (P=0.02) and interferon-γ (IFN-γ) (P=0.02) level in the critically patients were significantly higher than those in the general patients. The results showed that the incidence of acute gastrointestinal injury (AGI) and acute kidney injury (AKI) in critically ill patients was 39% and 23.5%, respectively. Moreover, there were 4% and 3.5% patients with the occurrence of cardiac arrest and acute live injury. The IFN-γ level was increased in these patients with acute liver injury compared to those without these organ injuries, but reduced in the patients with AGI compared to those without. The patients with AKI showed a significant increase in IL-10 in contrast to those without. The IL-2, IL-4, IL-6, IL-10 and IL-17A were higher in patients with acute liver failure (ALF), but TNF-α was reduced, compared to those without. The IL-2, IL-4, IL-6 and IL-10 were significantly increased in the patients with cardiac arrest compared to those without. When IL-10 was higher than 279.45 pg/mL, the sensitivity and specificity for predicting cardiac arrest were 0.875 and 0.927, respectively. While the sensitivity and specificity of IL-6 (more than 1,425.6 pg/mL) were 0.625 and 0.844, respectively. However, no synergistic effect of IL-6 and IL-10 was observed for predicting cardiac arrest. Additionally, the IL-17A (more than 21.6 pg/mL) was a good predictor for the incidence of ALF (sensitivity =0.714, specificity =0.876).The cytokines profile was different between critically ill patients with organ injury and those without organ injury. The IL-6 and IL-10 levels were good predictors for cardiac arrest in critically ill patients. Additionally, higher IL-17A predicted the incidence of ALF of the critically ill patients.2024 Translational Pediatrics. All rights reserved.