摘要
目的探讨血浆中多配体蛋白聚糖-1(syndecan-1,SDC-1)联合血小板计数(platelet count,PLT)、平均血小板体积(mean platelet volume,MPV)和血小板分布宽度(platelet distribution width,PDW)预测重症监护室(intensive care unit,ICU)的脓毒症患者死亡风险的价值。方法采用前瞻性单中心研究方法,选取2021年1~7月山西医科大学第一医院ICU收治的57例脓毒症患者,根据患者出ICU时的临床结局将其纳入生存组(n=36)和死亡组(n=21),比较患者入ICU后的第1、3、5和7天的SDC-1、PLT、MPV、PDW与临床结局的关系,并评估预测价值。采用GraphPad prism 8.02软件绘制受试者操作特征曲线(receiver operating characteristic curve,ROC)并计算曲线下面积(area under the curve,AUC)。结果生存组和死亡组患者的各指标在第3、5天比较,差异均有统计学意义(P<0.05),其中仅第3天的SDC-1与急性生理和慢性健康状况Ⅱ评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ)具有相关性(P<0.05);除第3天的PDW外,各指标与序贯器官衰竭评分(sequential organ failure assessment,SOFA)均具有相关性(P<0.05)。第3天SDC-1、PLT、MPV和PDW的AUC分别为0.698、0.702、0.702和0.678。第5天SDC-1、PLT、MPV和PDW的AUC分别为0.677、0.712、0.716和0.702。第3、5天四者联合的AUC分别为0.790和0.828。结论血浆中SDC-1、PLT、MPV和PDW与ICU的脓毒症患者病情的严重程度具有相关性,可用来预测患者死亡风险,且将四者联合可提高预测的价值。
Objective To investigate the value of plasma syndecan-1(SDC-1)combine with platelet count(PLT)and mean platelet volume(MPV)and platelet distribution width(PDW)in predicting the risk of death in patients with sepsis in intensive care unit(ICU).Methods Used prospective single-center study,a total of 57sepsis patients admitted to the ICU of the First Hospital of Shanxi Medical University from January to July 2021 were selected and included into the survival group(n=36)and death group(n=21)according to their clinical outcomes when they left ICU.SDC-1,PLT,MPV,PDW and clinical outcomes were compared on the 1st,3rd,5th and 7th days after ICU admission,and the predictive value was evaluated.GraphPad prism 8.02 software was used to draw the receiver operating characteristic curve(ROC)and calculate the area under the curve(AUC).Results There were statistically significant differences in each index between two groups on the 3rd and 5th day(P<0.05).Only SDC-1 on the 3rd day was correlated with Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score(P<0.05).All indexes were correlated with SOFA score except PDW on the 3rd day(P<0.05).On the 3rd day,the AUC of SDC-1,PLT,MPV and PDW was 0.698,0.702,0.702 and 0.678,respectively.On the 5th day,the AUC of SDC-1,PLT,MPV and PDW was 0.677,0.712,0.716 and 0.702,respectively.On days 3rd and 5th,the AUC of the combination was 0.790 and 0.828,respectively.Conclusion Plasma SDC-1,PLT,MPV and PDW are correlated with the severity of sepsis in ICU patients and could be used to predict the risk of death in patients,and the combination of the four can improve the predictive value.
作者
李福东
刘虹
韩继斌
雷建尧
LI Fudong;LIU Hong;HAN Jibin(The First Clinical Medical College of Shanxi Medical University,Shanxi 030001,China)
出处
《医学研究杂志》
2023年第3期87-91,共5页
Journal of Medical Research
基金
山西省自然科学基金资助项目(面上项目)(201901D111360)
山西省卫生和计划生育委员会科研基金资助项目(2018034)。
