摘要
目的探讨人成纤维细胞生长因子-21(FGF-21)、肾上腺髓质素前体中段肽(MR-proADM)水平变化与脓毒症患者预后的相关性。方法选择2019年6月—2021年2月本院收治的134例脓毒症患者为观察组,根据不同病情程度分为轻度组(42例)、重度组(54例)和休克组(38例)三组;另选取同期40名健康体检者为对照组。以酶联免疫法检测血清FGF-21水平,以免疫荧光法检测血清MR-proADM水平,比较脓毒症患者与健康体检者血清FGF-21、MR-proADM水平。采用急性生理与慢性健康评分(APACHEⅡ)评估脓毒症患者预后。比较不同病情程度脓毒症患者血清FGF-21、MR-proADM水平及APACHEⅡ评分,并分析其相关性。统计脓毒症患者病死情况,比较不同病情程度脓毒症患者病死率,比较病死及生存脓毒症患者入院前、入院3 d血清FGF-21、MR-proADM水平,分析血清FGF-21、MR-proADM水平对脓毒症患者病死的预测价值。结果观察组血清FGF-21、MR-proADM水平均高于对照组,差异有统计学意义(P<0.05)。不同病情程度脓毒症患者血清FGF-21、MR-proADM水平及APACHEⅡ评分比较,病情越严重血清FGF-21、MR-proADM水平及APACHEⅡ评分越高,差异均有统计学意义(P<0.05)。脓毒症患者血清FGF-21、MR-proADM水平与APACHEⅡ评分均呈正相关关系,差异均有统计学意义(P<0.05)。三组病死率比较有差异,且休克组死亡率42.11%(16/38)>重度组14.81%(8/54)>2.38%(1/42),差异均有统计学意义(P<0.05)。入院前、入院3 d病死患者血清FGF-21、MR-proADM水平均高于生存患者;入院3 d病死患者血清FGF-21、MR-proADM水平高于入院前,生存患者血清FGF-21、MR-proADM水平低于入院前,差异均有统计学意义(P<0.05)。血清FGF-21、MR-proADM水平评估脓毒症患者病死率的曲线下面积、灵敏性、特异性均较高。结论脓毒症患者血清FGF-21、MR-proADM均呈高水平表达,且与APACHEⅡ评分呈正相关关系,血清FGF-21、MR-proADM水平越高预示�
Objective To analyze the correlation between the changes of human fibroblast growth factor-21(FGF-21),adrenomedullin precursor mid-segment peptide(MR-proADM)and the prognosis of patients with sepsis.Methods A total of 134 patients with sepsis those were admitted to our hospital from June 2019 to February 2021 were selected as the observation group,and they were divided into mild group(n=42),severe group(n=54),shock group(n=38)according to disease conditions.Another 40 healthy objects received physical examination in our hospital during the same period were selected as the control group.The serum FGF-21 level was detected by enzyme-linked immunosorbent assay,and the serum MR-proADM level was detected by immunofluorescence method.The serum FGF-21,MR-proADM level of sepsis patients and healthy objects were compared.The acute physiology and chronic health score(APACHEⅡ)was used to assess the prognosis of patients with sepsis,and the serum FGF-21,MR-proADM levels and APACHEⅡscores of sepsis patients with different disease levels were compared,and their correlations were analyzed.To compare the mortality of patients with sepsis,compare the mortality of sepsis patients with different severity,compare the serum FGF-21 and MR-proADM levels of patients with sepsis before admission and 3 days after admission,and analyze the predictive value ofserumFGF-21 and MR-proADM level for the death of patients with sepsis.Results The levels of serum FGF-21 and MR-proADM in the observation group were higher than those in the control group(P<0.05);there were statistically significant differences in the levels of serum FGF-21,MR-proADM and APACHEⅡscores in patients with sepsis of different severity.The more severe the disease,the higher the serum FGF-21,MR-proADM level and APACHEⅡscore(P<0.05);Serum FGF-21 and MR-proADM levels in patients with sepsis were positively correlated with APACHEⅡscore(P<0.05);The difference in mortality between the three groups was statistically significant,and the mortality rate in the shock group wa
作者
李自平
刘湛
Li Ziping;Liu Zhan(Department of clinical laboratory,people's hospital of Puyang,Puyang,Henan,457000,China.)
出处
《齐齐哈尔医学院学报》
2022年第2期161-164,共4页
Journal of Qiqihar Medical University
