摘要
目的 探讨重症急性胰腺炎(SAP)合并腹腔感染患者血浆线粒体DNA(mtDNA)水平与感染严重程度及患者临床预后的关系。方法 选择酒泉市人民医院急诊科2018年3月-2021年3月收治的SAP患者,将发生腹腔感染患者45例纳入研究组和未发生腹腔感染患者45例纳入对照组。患者在住院后收集其性别、年龄、住院天数和合并脏器衰竭、入院当天急性生理与慢性健康评分(APACHEⅡ)和Rason评分,对腹腔感染严重程度及预后进行评估。检测研究组患者在腹腔感染诊断次日清晨、对照组患者在入院后C-反应蛋白(CRP)、降钙素原(PCT)和D-二聚体水平。采用实时荧光定量聚合酶链式反应检测外周血中mtDNA拷贝数水平。结果 研究组入院时APACHEⅡ评分、Rason评分、住院天数和合并器官衰竭例数高于对照组(P<0.05);研究组mtDNA、CRP、PCT和D-二聚体水平高于对照组(P<0.05);相关性分析结果显示研究组患者外周血mtDNA水平与血清CRP、PCT和D-二聚体水平均呈正相关关系(P<0.05);ROC分析结果显示,mtDNA单指标用于SAP合并腹腔感染患者预后预测曲线下面积为0.825,CRP、PCT、D二聚体为0.756、0.760和0.780,当4指标联合时曲线下面积为0.893(P<0.05)。结论 血浆mtDNA水平对于SAP患者腹腔感染与否、严重程度及预后有一定的评估价值,与其他感染性血液学指标联合应用时可提高其评估效能。
OBJECTIVE To explore the correlation of plasma mitochondrial DNA(mtDNA) level with the severity of the infection and the prognosis in severe acute pancreatitis(SAP) patients complicated with abdominal infection. METHODS Forty-five patients with SAP and intra-abdominal infection admitted to the Emergency Department of Jiuquan People’s Hospital from Mar 2018 to Mar 2021 were enrolled as the research group, and 45 SAP patients without intra-abdominal infection admitted to the hospital during the same period were in the control group. After hospitalization, the patients’ gender, age, length of hospital stay, combined organ failure, acute physiology and chronic health score(APACHE II) and Rason score on the day of admission were collected to evaluate the severity and prognosis of abdominal infection. The levels of C-reactive protein(CRP), procalcitonin(PCT) and D-dimer in the patients of the study group were detected in the morning of the next day after diagnosis of abdominal infection. The copy number of mtDNA in peripheral blood was detected by real-time fluorescence quantitative polymerase chain reaction. RESULTS The APACHE II score, Rason score, length of hospital stay and the number of patients with organ failure at admission in the study group were significantly higher than those in the control group(P<0.05);the levels of mtDNA, CRP, PCT and D-dimer in the study group were significantly higher than those in the control group(P<0.05). Correlation analysis showed that the level of mtDNA in peripheral blood of the study group was positively correlated with the levels of serum CRP, PCT and D-dimer(P<0.05). ROC analysis showed that the area under the curves of individual indexes of mtDNA, CRP, PCT and D-dimer levels for predicting the prognosis of patients were 0.825, 0.756, 0.760 and 0.780, respectively, that of the combination of the four indexes was 0.893(P<0.05). CONCLUSION Plasma mtDNA level have certain assessment value for the prediction of abdominal infection, severity and prognosis in SAP patients, and t
作者
南文波
王亚红
白雪芬
车芬霞
NAN Wen-bo;WANG Ya-hong;BAI Xue-fen;CHE Fen-xia(Jiuquan People's Hospital,Jiuquan,Gansu 735000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第16期2496-2500,共5页
Chinese Journal of Nosocomiology
基金
甘肃省医药卫生科研基金资助项目(19A0304)。
关键词
重症急性胰腺炎
腹腔感染
线粒体DNA
急性生理与慢性健康评分
预后
Cultural acute pancreatitis
Abdominal infection
Mitochondrial DNA
Acute physiology and chronic health score
Prognosis
