摘要
目的探究血清生长分化因子15(GDF-15)、白细胞介素-33(IL-33)联合检测在重症监护室(ICU)老年肺部感染患者诊断及预后中的应用价值。方法选取2021年2月至2023年2月入住该院ICU的73例肺部感染老年患者作为研究组,依据治疗30 d后患者的预后情况,将研究组分为生存组(52例)和死亡组(21例)。另选取同期入住该院ICU但未发生肺部感染的老年患者70例作为对照组。收集所有研究对象的临床资料进行比较分析,酶联免疫吸附试验(ELISA)检测所有研究对象血清中GDF-15、IL-33水平,通过多因素Logistic回归分析影响ICU老年肺部感染患者预后的因素,采用受试者工作特征(ROC)曲线分析血清GDF-15、IL-33水平对ICU老年肺部感染患者的诊断及预后评估的价值。结果与对照组比较,研究组血清GDF-15、IL-33水平均显著升高(P<0.05)。血清GDF-15、IL-33水平为ICU老年患者发生肺部感染的独立危险因素(P<0.05)。血清GDF-15、IL-33水平诊断ICU老年患者发生肺部感染的曲线下面积(AUC)分别为0.912、0.896、0.951,二者联合检测的AUC大于GDF-15、IL-33单独诊断(Z_(二者联合-GDF-15)=2.630、Z_(二者联合-IL-33)=2.432,P=0.009、0.015)。生存组与死亡组年龄、体质量指数、性别、血小板计数、血清肌酐、血红蛋白、尿素氮比较,差异均无统计学意义(P>0.05);而死亡组白细胞计数、中性粒细胞计数及血清GDF-15、IL-33水平均高于生存组(P<0.05),淋巴细胞计数低于生存组(P<0.05)。多因素Logistic回归分析结果显示,中性粒细胞计数、白细胞计数、血清GDF-15、IL-33水平为ICU老年肺部感染患者发生死亡的独立危险因素(P<0.05),淋巴细胞计数为ICU老年肺部感染患者发生死亡的独立保护因素(P<0.05)。血清GDF-15、IL-33单独及二者联合预测ICU老年肺部感染患者预后情况的AUC分别为0.870、0.836、0.960,二者联合检测的AUC大于GDF-15、IL-33单独诊断(Z_(二者联合-GDF-15)=2.521
Objective To explore the application value of serum growth differentiation factor 15(GDF-15)combined interleukin-33(IL-33)in the diagnosis and prognosis of elderly pulmonary infection patients in intensive care unit(ICU).Methods A total of 73 elderly patients with pulmonary infection admitted to the ICU in the hospital from February 2021 to February 2023 were collected as study group.Based on the prognosis of the patients after 30 days of treatment,study group was separated into a survival group(52 cases)and a death group(21 cases).Another 70 elderly patients who were admitted to the ICU in the hospital but did not have pulmonary infection were taken as control group.All clinical data of the study subjects were collected for comparative analysis.Enzyme linked immunosorbent assay(ELISA)was applied to detect the levels of GDF-15 and IL-33 in the serum of all study subjects.Multivariate Logistic regression was applied to analyze the factors affecting the prognosis of elderly patients with pulmonary infection in ICU.Receiver operating characteristic(ROC)curve was applied to analyze the value of serum GDF-15 and IL-33 levels in the diagnosis and prognosis evaluation of elderly pulmonary infection patients in ICU.Results Compared with control group,the serum levels of GDF-15 and IL-33 in study group were obviously higher(P<0.05).Serum levels of GDF-15 and IL-33 were independent risk factors for lung infection in elderly ICU patients(P<0.05).The area under the curve(AUC)of serum GDF-15 and IL-33 levels for diagnosing pulmonary infection in elderly ICU patients was 0.912,0.896,and 0.951,respectively,and the AUC of the combined detection of the two was larger than that of GDF-15 and IL-33 alone(Z_(combined diagnosis-GDF-15)=2.630,Z_(combined diagnosis-IL-33)=2.432,P=0.009,0.015).There were no statistically significant differences in age,gender,body mass index,platelet count,serum creatinine,hemoglobin,and urea nitrogen between the survival group and the death group(P>0.05).The white blood cell count,neutrophil count,and s
作者
杨翠英
赵峥
张亮亮
刘卓
靳兆
YANG Cuiying;ZHAO Zheng;ZHANG Liangliang;LIU Zhuo;JIN Zhao(First Department of Chest Surgery,West District,Handan Central Hospital,Handan,Hebei 056000,China)
出处
《国际检验医学杂志》
CAS
2024年第24期3021-3025,共5页
International Journal of Laboratory Medicine
关键词
重症监护室
肺部感染
生长分化因子15
白细胞介素-33
诊断
预后
intensive care unit
pulmonary infection
growth differentiation factor 15
interleukin-33
diagnosis
prognosis
