摘要
目的研究严重腹腔感染患者血清炎性指标表达水平与病情严重程度的相关性。方法选取2016年12月-2018年3月南阳市医学高等专科学校第一附属医院严重腹腔感染患者86例,设为严重感染组;普通腹腔感染患者44名,设为普通感染组;健康体检人员44例,设为对照组。监测严重感染组、普通感染组患者感染发生时(T0)、感染24 h(T1)、感染48 h(T2)、感染控制后(T3)的白细胞计数(WBC)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)水平和急性生理和慢性健康评分(APACHEⅡ)系统评分及对照组上述指标变化,并分析其相关性。结果T0时,严重感染组WBC、TNF-α、IL-6、hs-CRP和APACHEⅡ分别为(22.40±4.70)×10^9/L、(298.00±87.50)pg/ml、(368.00±75.00)ng/L、(26.80±6.90)mg/L和(27.50±4.30)分高于普通感染组和对照组,且普通感染组高于对照组(P<0.05);T0~T3时,严重感染组和普通感染组WBC、TNF-α、IL-6、hs-CRP水平和APACHEⅡ均先升高、后下降,但每个时刻严重感染组均高于普通感染组(P<0.05)。T0时,严重腹腔感染死亡患者WBC、TNF-α、IL-6、hs-CRP和APACHEⅡ分别为(25.00±4.90)×10^9/L、(312.00±89.50)pg/ml、(384.00±72.00)ng/L、(28.80±7.10)mg/L和(30.40±4.20)分均高于存活者(P<0.05);死亡者WBC、TNF-α、IL-6、hs-CRP水平和APACHEⅡ系统评分持续性升高,存活者先升高、后下降,差异均有统计学意义(P<0.05);且死亡者每个时刻WBC、TNF-α、IL-6、hs-CRP水平和APACHEⅡ系统评分均高于存活者(P<0.05)。血清TNF-α、IL-6、hs-CRP及三者联合检测曲线下面积(AUC)分别为0.794、0.689、0.618、0.924;敏感度分别为0.744、0.674、0.674、0.965,特异度分别为0.659、0.614、0.591、0.818。TNF-α、IL-6、hs-CRP水平与WBC、APACHEⅡ评分分别呈正相关(P<0.05)。结论血清炎性指标表达高低与严重腹腔感染者病情严重程度具有一定相关性,利于界定感染危险层级,可作为评定严重腹腔感
OBJECTIVE To study the correlation between the expression level of serum inflammatory markers and the severity of the disease in patients with severe abdominal infection.METHODS From Dec.2016 to Mar.2018,86 patients with severe abdominal infection were selected as the severe infection group,44 patients with common abdominal infection were included in the general infection group,and 44 healthy people who received physical examination were included in the control group.The white blood cell count(WBC),tumor necrosis factor-α(TNF-α),Interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)levels,and acute physiological and chronic health scores(APACHE II)system scores when the infection occurred(T0),24 h after infection(T1),48 h after infection(T2),after the infection was controlled(T3)in the severe infection group and the general infection group,and the changes of these indexes in the control group were monitored to determine their relevance.RESULTS At T0,the WBC,TNF-α,IL-6,hs-CRP and APACHE II system scores in the severe infection group[(22.40±4.70)×10^9/L,(298.00±87.50)pg/ml,(368.00±75.00)ng/L,(26.80±6.90)mg/L and(27.50±4.30)]were higher than those in the normal infection group and the control group.The indexes in the common infection group were significantly higher than those in the control group(P<0.05).At T1,T2,T3,the WBC,TNF-α,IL-6,hs-CRP levels and APACHE II system scores of the severe infection group and the common infection group increased first and then decreased,but the indexes in the severe infection group at all time points were significantly higher than those in the normal infection group(P<0.05).At T0,the WBC,TNF-α,IL-6,hs-CRP and APACHE II system scores of the patients with severe abdominal infection who died[(25.00±4.90)×10^9/L,(312.00±89.50)pg/ml,(384.00±72.00)ng/L,(28.80±7.10)mg/L and(30.40±4.20)]were significantly higher than those of the survivors(P<0.05).At T1,T2,T3,the WBC,TNF-α,IL-6,hs-CRP levels and APACHE II system scores of the dead continued to increase,and the sur
作者
李宇飞
吴勤祥
李琰
司建炜
丁恒一
LI Yu-fei;WU Qin-xiang;LI Yan;SI Jian-wei;DING Heng-yi(First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第19期2976-2981,共6页
Chinese Journal of Nosocomiology
基金
河南省高校重点科研基金资助项目(16A352135)
关键词
严重腹腔感染
病情
炎性指标
相关性
Severe abdominal infection
Condition
Inflammatory index
Correlation
