摘要
目的探究脓毒症患者血清可溶性肿瘤坏死因子受体Ⅱ(sTNFR-Ⅱ)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、人中性粒细胞多肽1-3(HNP1-3)水平与全身炎症反应综合征(SIRS)评分相关性,并采用受试者工作特征(ROC)曲线评价各血清指标预测预后价值。方法选取遂宁市中心医院2016年1月—2021年3月收治的120例脓毒症患者,随访30 d,根据预后分为生存组(98例)与死亡组(22例),检测对比两组血清sTNFR-Ⅱ、GM-CSF、HNP1-3水平,分析各血清指标与SIRS评分相关性及预测预后价值。结果死亡组血清sTNFR-Ⅱ、GM-CSF、HNP1-3水平高于生存组(P<0.05);Pearson相关性分析,血清sTNFR-Ⅱ、GM-CSF、HNP1-3与SIRS评分呈正相关(P<0.05);COX回归分析,将年龄、病情程度、侵入性操作、SIRS评分等其他因素调整后,血清sTNFR-Ⅱ、GM-CSF、HNP1-3与死亡风险显著相关(P<0.05);ROC曲线分析,血清sTNFR-Ⅱ、GMCSF、HNP1-3联合预测预后的AUC为0.833,95%CI为0.754~0.895,敏感性为90.91%,特异性为62.24%,较各血清指标单独预测价值显著提高(P<0.05)。结论脓毒症患者血清sTNFR-Ⅱ、GM-CSF、HNP1-3水平与SIRS评分呈正相关,联合检测可作为预测预后的新思路、新途径。
Objective To explore the serum soluble tumor necrosis factor receptor II(sTNFR-II),granulocytemacrophage colony stimulating factor(GM-CSF),human neutrophil polypeptide 1-3(HNP1-3)in patients with sepsis The level is correlated with the systemic inflammatory response syndrome(SIRS)score,and the receiver operating characteristic(ROC)curve is used to evaluate the prognostic value of each serum index.Methods 120 septicemia patients with sepsis in Suining Central Hospital from January 2016 to March 2021 were followed up for 30 days.They were divided into survival group(98 cases)and death group(22 cases)according to the prognosis.The levels of serum sTNFR-Ⅱ,GM-CSF and HNP1-3 in the two groups were detected and compared.The correlation between serum indexes and SIRS score and the prognostic value were analyzed.Results The levels of serum sTNFR-Ⅱ,GM-CSF and HNP1-3 in the death group were higher than those in the survival group(P<0.05);Pearson correlation analysis showed that serum sTNFR-Ⅱ,GM-CSF and HNP1-3 were positively correlated with SIRS score(P<0.05);Cox regression analysis showed that serum sTNFR-Ⅱ,GM-CSF and HNP1-3 were significantly correlated with the risk of death(P<0.05);ROC curve analysis showed that the AUC of serum sTNFR-Ⅱ,GM-CSF and HNP1-3 in predicting prognosis was 0.833,95%CI was 0.754~0.895,the sensitivity was 90.91%,and the specificity was 62.24%,which was significantly higher than that of serum indexes alone(P<0.05).Conclusion Serum sTNFR-Ⅱ,GM-CSF,HNP1-3 levels in patients with sepsis are positively correlated with SIRS scores.Combined detection can be used as a new idea and new way to predict prognosis.
作者
龙瀛
杜发旺
姚宇
胡建平
LONG Ying;DU Fawang;YAO Yu;HU Jianping(Suining Central Hospital,Suining Sichuang 629000,China)
出处
《中国急救复苏与灾害医学杂志》
2022年第4期474-477,481,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
2019年四川省医学会静脉栓塞症防治专项科研课题(编号:2019HR57)。
