目的探究血清降钙素原(procalcitonin,PCT)、白蛋白(albumin,ALB)、胰石蛋白(pancreatic stone protein,PSP)联合预测脓毒症患儿预后的临床价值。方法选取脓毒症患儿322例为研究对象,根据患儿病情严重程度分为脓毒症组126例、严重脓毒症...目的探究血清降钙素原(procalcitonin,PCT)、白蛋白(albumin,ALB)、胰石蛋白(pancreatic stone protein,PSP)联合预测脓毒症患儿预后的临床价值。方法选取脓毒症患儿322例为研究对象,根据患儿病情严重程度分为脓毒症组126例、严重脓毒症组105例、脓毒性休克组91例,另选取健康儿童80例为对照组。比较各组血清PCT、ALB及PSP水平,分析脓毒症患儿预后的相关影响因素,应用ROC曲线评估PCT、ALB及PSP对脓毒症患儿预后的预测价值。结果4组血清PCT、ALB及PSP水平比较差异有统计学意义(P<0.05);脓毒症组PCT、PSP水平高于对照组,ALB水平低于对照组,严重脓毒症组PCT、PSP水平高于脓毒症组和对照组,ALB水平低于脓毒症组和对照组,脓毒性休克组PCT、PSP水平高于严重脓毒症组、脓毒症组和对照组,ALB水平低于严重脓毒症组、脓毒症组和对照组,差异有统计学意义(P<0.05)。随访28 d,322例患儿中死亡48例(14.91%),存活274例(85.09%)。严重脓毒症组病死率高于脓毒症组,脓毒性休克组病死率高于脓毒症组和严重脓毒症组,差异有统计学意义(P<0.01)。死亡组PCT和PSP水平高于存活组,ALB水平和PCIS评分低于存活组,差异有统计学意义(P<0.05)。多因素Logistic回归分析,结果显示,血清PCT、ALB、PSP及PCIS评分是脓毒症患儿死亡的危险因素(P<0.05)。ROC曲线显示,血清PCT、ALB、PSP对脓毒症患儿死亡具有一定预测价值(曲线下面积,area under curve,AUC=0.741、0.783、0.784,P<0.01),三项联合的敏感度、特异度为87.5%、91.6%,预测价值较高(AUC=0.953,P<0.01)。结论血清PCT、ABL、PSP水平对脓毒症患儿预后均有一定的预测价值,三者者联合预测的特异度、敏感度较高,对预后的预测更加准确,临床可加强监测。展开更多
目的血清胰石蛋白(pancreatic stone protein,PSP)水平改变对于呼吸机相关性肺炎(ventilator associated pneumonia,VAP)患者临床预后的预测研究。方法本研究连续性纳入2013-01/2015-12月在作者医院重症加强护理病房(intensive care uni...目的血清胰石蛋白(pancreatic stone protein,PSP)水平改变对于呼吸机相关性肺炎(ventilator associated pneumonia,VAP)患者临床预后的预测研究。方法本研究连续性纳入2013-01/2015-12月在作者医院重症加强护理病房(intensive care unit,ICU)住院治疗的60例VAP患者。分别与机械通气(mechanical ventilation,MV)开始时、诊断VAP当天以及诊断后第四天3个时间点进行白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-10(interleukin-10,IL-10)、降钙素原(procalcitonin,PCT)和PSP检验和记录。选取并未出现VAP的患者40例作为对照组,分别在MV开始时,开始后第四天和第八天进行以上指标检测。结果 VAP组患者VAP诊断当天和诊断后第四天的IL-10、PCT和PSP水平明显高于MV开始时水平,组间比较差异具有统计学意义(P<0.05),IL-1β水平明显低于MV开始时,组间比较差异具有统计学意义(P<0.05)。死亡亚组患者VAP诊断当天和诊断后第四天的IL-10,PCT和PSP水平明显高于MV开始时水平,组间比较差异具有统计学意义(P<0.05)。受试者工作特征曲线(receiver operating characteristic curve,ROC)分析提示VAP诊断时PSP水平和PSP改变值△1可以对VAP患者28 d死亡率具有一定的预测价值。相关性分析提示VAP诊断时和VAP诊断后第四天PSP水平与VAP死亡率呈正相关(P<0.05),而PSP改变值△1和△2与VAP死亡率呈负相关(P<0.05)。Logistics回归分析提示VAP诊断时PSP,VAP诊断后第四天PSP和△1PSP水平为VAP患者死亡的独立危险因素。结论 PSP可以作为新型预测VAP患者临床预后的生物学标记物。展开更多
Objective: To study the changes of serum pancreatic stone protein (PSP) and cholinesterase (ChE) contents in children with sepsis and their correlation with systemic inflammatory response and target organ damage. Meth...Objective: To study the changes of serum pancreatic stone protein (PSP) and cholinesterase (ChE) contents in children with sepsis and their correlation with systemic inflammatory response and target organ damage. Methods: A total of 64 children with sepsis who were treated in the hospital between January 2015 and January 2017 were selected as observation group, and 50 healthy children who received vaccination in the hospital during the same period were selected as normal control group. The contents of PSP, ChE, inflammatory factors as well as liver and kidney function indexes in the two groups were detected. Pearson test was used to assess the correlation of serum PSP and ChE contents with systemic inflammatory response and target organ damage in children with sepsis. Results: Serum PSP content of observation group was higher than that of control group while ChE content was lower than that of control group;serum inflammatory factors PCT, CRP, IL-1, IL-6 and IL-10 contents of observation group were higher than those of normal control group;liver function indexes TBIL, ALT and AST contents were higher than those of normal control group;kidney function indexes Scr and BUN contents were higher than those of normal control group. Pearson test showed that the serum PSP and ChE contents in children with sepsis were directly correlated with the systemic inflammatory response as well as liver and renal function injury. Conclusion: Serum PSP content significantly increases while ChE content significantly decreases in children with sepsis and the specific change is directly correlated with the overall disease severity.展开更多
文摘目的探究血清降钙素原(procalcitonin,PCT)、白蛋白(albumin,ALB)、胰石蛋白(pancreatic stone protein,PSP)联合预测脓毒症患儿预后的临床价值。方法选取脓毒症患儿322例为研究对象,根据患儿病情严重程度分为脓毒症组126例、严重脓毒症组105例、脓毒性休克组91例,另选取健康儿童80例为对照组。比较各组血清PCT、ALB及PSP水平,分析脓毒症患儿预后的相关影响因素,应用ROC曲线评估PCT、ALB及PSP对脓毒症患儿预后的预测价值。结果4组血清PCT、ALB及PSP水平比较差异有统计学意义(P<0.05);脓毒症组PCT、PSP水平高于对照组,ALB水平低于对照组,严重脓毒症组PCT、PSP水平高于脓毒症组和对照组,ALB水平低于脓毒症组和对照组,脓毒性休克组PCT、PSP水平高于严重脓毒症组、脓毒症组和对照组,ALB水平低于严重脓毒症组、脓毒症组和对照组,差异有统计学意义(P<0.05)。随访28 d,322例患儿中死亡48例(14.91%),存活274例(85.09%)。严重脓毒症组病死率高于脓毒症组,脓毒性休克组病死率高于脓毒症组和严重脓毒症组,差异有统计学意义(P<0.01)。死亡组PCT和PSP水平高于存活组,ALB水平和PCIS评分低于存活组,差异有统计学意义(P<0.05)。多因素Logistic回归分析,结果显示,血清PCT、ALB、PSP及PCIS评分是脓毒症患儿死亡的危险因素(P<0.05)。ROC曲线显示,血清PCT、ALB、PSP对脓毒症患儿死亡具有一定预测价值(曲线下面积,area under curve,AUC=0.741、0.783、0.784,P<0.01),三项联合的敏感度、特异度为87.5%、91.6%,预测价值较高(AUC=0.953,P<0.01)。结论血清PCT、ABL、PSP水平对脓毒症患儿预后均有一定的预测价值,三者者联合预测的特异度、敏感度较高,对预后的预测更加准确,临床可加强监测。
文摘Objective: To study the changes of serum pancreatic stone protein (PSP) and cholinesterase (ChE) contents in children with sepsis and their correlation with systemic inflammatory response and target organ damage. Methods: A total of 64 children with sepsis who were treated in the hospital between January 2015 and January 2017 were selected as observation group, and 50 healthy children who received vaccination in the hospital during the same period were selected as normal control group. The contents of PSP, ChE, inflammatory factors as well as liver and kidney function indexes in the two groups were detected. Pearson test was used to assess the correlation of serum PSP and ChE contents with systemic inflammatory response and target organ damage in children with sepsis. Results: Serum PSP content of observation group was higher than that of control group while ChE content was lower than that of control group;serum inflammatory factors PCT, CRP, IL-1, IL-6 and IL-10 contents of observation group were higher than those of normal control group;liver function indexes TBIL, ALT and AST contents were higher than those of normal control group;kidney function indexes Scr and BUN contents were higher than those of normal control group. Pearson test showed that the serum PSP and ChE contents in children with sepsis were directly correlated with the systemic inflammatory response as well as liver and renal function injury. Conclusion: Serum PSP content significantly increases while ChE content significantly decreases in children with sepsis and the specific change is directly correlated with the overall disease severity.
