摘要
目的探讨血清降钙素原(PCT)、白细胞介素⁃6(IL⁃6)、N⁃末端脑钠肽前体(NT⁃proB⁃NP)、高敏心肌肌钙蛋白T(hs⁃TnT)在早期急诊脓毒症患者中的诊断价值。方法选取88例2018年5月至2021年5月就诊于东营区人民医院的脓毒症患者作为研究组,选取53例同期健康体检者为对照组,另选取38例同期内毒素血症患者作为非脓毒症组,比较三组及不同病情程度脓毒症患者血清PCT、IL6、NT⁃proBNP、hs⁃TnT水平,并比较不同病情程度患者序贯器官衰竭(SOFA)评分、急性生理与慢性健康评分状况Ⅱ(APACHEⅡ)评分,Pearson相关性分析上述血清指标与SOFA、APACHEⅡ评分相关性,受试者工作特征曲线(ROC)评估血清指标联合对早期急诊脓毒症患者的诊断价值,比较高危、低危组生存率。结果3组血清PCT、IL6、NT⁃proBNP、hs⁃TnT水平比较:研究组>非脓毒症组>对照组,差异有统计学意义(P<0.05);重症组血清PCT、IL6、NT⁃proBNP、hs⁃TnT水平及APACHEⅡ、SOFA评分较轻症组高,差异有统计学意义(P<0.05);经Pearson相关性分析,PCT、IL6、NT⁃proBNP、hs⁃TnT与APACHEⅡ、SOFA评分呈显著正相关(P<0.05);PCT、IL⁃6、NT⁃proBNP、hs⁃TnT联合诊断敏感度为84.09%,特异度为86.79%,AUC值为0.930,优于单一诊断(P<0.05);与PCT、IL6、NT⁃proBNP、hs⁃TnT高危组病死率相比,低危组病死率较低,差异有统计学意义(P<0.05)。结论血清PCT、IL6、NT⁃proBNP、hs⁃TnT在早期急诊脓毒症患者中呈高表达,对于早期急诊脓毒症患者具有一定诊断价值,为临床评估预后提供比较可靠依据。
Objective To investigate serum procalcitonin(PCT),interleukin⁃6(IL⁃6),N⁃terminal precursor brain natriuretic peptide(NT⁃proBNP),high⁃sensitivity cardiac troponin T(hs⁃TnT)Diagnostic value in early emergency sepsis patients.Methods A total of 88 patients with sepsis who were treated in our hospital from May 2018 to May 2021 were selected as the experimental group,and 38 healthy subjects during the same period were selected as the control group,The serum levels of PCT,IL6,NT⁃proBNP and hs⁃TnT were compared between the two groups and patients with different disease degrees,and the sequential organ failure(SOFA)scores and acute physiology and chronic health statusⅡ(APACHEⅡ)scores in patients with different disease degrees were compared.Pearson correlation analysis was performed to analyze the correlation between the above serum indicators and SOFA and APACHE II scores.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of serum indicators combined in patients with early emergency sepsis,and compared the survival rates of high⁃risk and low⁃risk groups.Results Comparison of serum PCT,IL6,NT⁃proBNP,hs⁃TnT levels among the three groups:study group>non⁃sepsis group>control group,the difference was statistically significant(P<0.05).Serum PCT,IL6,NT⁃proBNP,hs⁃TnT levels and APACHEⅡand SOFA scores in the serve group were higher than those in the mild disease group,and the difference was statistically significant(P<0.05).The combined diagnostic sensitivity of PCT,IL⁃6,NT⁃proBNP and hs⁃TnT was 84.09%,the specificity was 86.79%,and the AUC value was 0.930,which was better than the single diagnosis(P<0.05).Compared with the high⁃risk group of PCT,IL6,NT⁃proBNP,and hs⁃TnT,the low⁃risk group had a lower mortality,and the difference was statistically significant(P<0.05).Conclusion Serum PCT,IL6,NT⁃proBNP,and hs⁃TnT are highly expressed in patients with early emergency sepsis,which have certain diagnostic value for patients with early emergen
作者
王伟
刘丰芹
贾方兰
WANG Wei;LIU Fengqin;JIA Fanglan(Public Health Department,Dongying District People's Hospital,Dongying,Shandong,China,257000;Dental Department,Dongying District People's Hospital,Dongying,Shandong,China,257000;Traditional Chinese Medicine Department,Dongying New District Hospital,Dongying,Shandong,China,257000)
出处
《分子诊断与治疗杂志》
2022年第4期643-646,651,共5页
Journal of Molecular Diagnostics and Therapy
基金
山东省中医药科技发展计划项目(2019⁃0468)。
