摘要
目的 探讨ICU重症感染患者血清C-反应蛋白(CRP)、内毒素(ETX)、肝素结合蛋白(HBP)表达及其对预后的价值.方法 选取2018年1月-2019年7月河南省人民医院ICU收治的重症感染患者92例作为研究对象,根据28 d预后情况分为生存组(77例)、病死组(15例).比较两组患者入住ICU、治疗48 h、72 h后血清CRP、ETX、HBP水平、序贯器官衰竭估计(SOFA)评分、急性生理与慢性健康(APACHEⅡ)评分,Pearson相关性分析血清CRP、ETX、HBP与SOFA、APACHEⅡ评分相关性,受试者工作特征(ROC)曲线分析血清CRP、ETX、HBP对预后的价值,并采用Kaplan-Meier曲线进行生存分析.结果 入院时两组患者血清CRP、ETX、HBP水平比较差异无统计学意义;治疗48 h、72 h后生存组血清CRP、ETX、HBP水平均低于病死组(P<0.05);治疗48 h、72 h后生存组SOFA、APACHEⅡ评分均低于病死组(P<0.05);经Pearson分析,治疗48 h、72 h后血清CRP、ETX、HBP水平与SOFA、APACHEⅡ评分呈正相关(P<0.05);ROC曲线分析显示,治疗72 h后HBP的曲线下面积(AUC)最大,为0.807;随访28 d,Kaplan-Meier曲线分析显示,高危组、低危组血清CRP、ETX、HBP生存曲线对比,差异有统计学意义(P<0.05).结论 血清CRP、ETX、HBP水平与ICU重症感染患者预后关系密切,可为预后评估提供客观依据,临床动态监测其水平变化对提高患者生存率具有重要意义.
OBJECTIVE To explore the expression of serum C-reactive protein(CRP),endotoxin(ETX),and heparin binding protein(HBP)in the ICU patients with severe infection and analyze the value in prediction of prognosis.METHODS A total of 92 patients with severe infection who were treated in ICUs of Henan Provincial People′s Hospital form Jan 2018 to Jul 2019 were recruited as the study objects and were divided into the survival group with 77 cases and the death group with 15 cases according to the 28-day prognosis.The serum CRP,ETX,HBP levels,sequential organ failure assessment(SOFA)score and acute physiology and chronic healthⅡ(APACHEⅡ)score were compared between the two groups of patients at admission to ICU and after the treatment for 48 and 72 hours,Pearson correlation analysis was performed to observe the correlation between the serum CRP,ETX,HBP and the SOFA,APACHEⅡscores,the value of serum CRP,ETX and HBP in prediction of prognosis was analyzed by means of receiver operating characteristic(ROC)curve,and the survival analysis was carried out with the use of Kaplan-Meier curve.RESULTS There were no significant difference in the levels of serum CRP,ETX and HBP between the two groups of patients at the admission to hospital;the levels of serum CRP,ETX and HBP of the survival group were significantly lower than those of the death group after the treatment for 48 and 72 hours(P<0.05).The SOFA score and APACHEⅡscore of the survival group were significantly lower than those of the death group after the treatment for 48 and 72 hours(P<0.05).Pearson analysis showed that the levels of serum CRP,ETX and HBP were positively correlated with the SOFA score and APACHEⅡscore after the treatment for 48 and 72 hours(P<0.05);ROC curve analysis indicated that the area under curve(AUC)of the HBP was the largest(0.807)after the treatment for 72 hours.During a 28-day follow-up,the Kaplan-Meier curve analysis showed that there were significant differences in the serum CRP,ETX,and HBP survival curves between the high-risk group and
作者
李晓慧
岳胜
杜小静
秦秉玉
梁凯
LI Xiao-hui;YUE Sheng;DU Xiao-jing;QIN Bing-yu;LIANG Kai(Henan Provincial People′s Hospital,Central China Fuwai Hospital,Central China Fuwai Hospital of Zhengzhou University,Zhengzhou,Henan 450003,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第17期2647-2651,共5页
Chinese Journal of Nosocomiology
基金
河南省医学科技攻关计划基金资助项目(201702162)。
