摘要
目的探讨血清可溶性髓样细胞触发受体-1(sTREM-1)、成纤维细胞生长因子-21(FGF-21)与感染性休克患者预后的关系。方法选择2019年7月-2021年12月万宁市人民医院收治的97例感染性休克患者作为研究对象,根据28 d预后情况分为死亡组(n=34)及生存组(n=63),另选同期50名健康体检者作为对照组。检测并比较所有受试者血清sTREM-1、FGF-21、白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)水平,比较不同预后患者序贯性器官功能衰竭评估(SOFA)评分及急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分,采用Pearson系数分析血清sTREM-1、FGF-21、WBC、CRP、PCT与SOFA评分及APACHE Ⅱ评分的相关性,采用受试者工作特征曲线(ROC)分析血清sTREM-1、FGF-21、WBC、CRP、PCT对感染性休克患者预后的评估价值。结果感染性休克组血清sTREM-1、FGF-21、WBC、CRP、PCT水平均高于对照组,差异均有统计学意义(t=24.266、31.743、30.236、27.916、28.904,P均<0.05);感染性休克死亡组血清sTREM-1、FGF-21、WBC、CRP、PCT水平均高于生存组,差异均有统计学意义(t=8.518、8.817、7.284、5.060、7.573,P均<0.05);感染性休克死亡组SOFA评分及APACHE Ⅱ评分均高于生存组,差异均有统计学意义(t=7.052、8.143,P均<0.05);Pearson相关性分析结果显示,感染性休克患者血清sTREM-1、FGF-21、WBC、CRP、PCT水平均与SOFA评分及APACHEⅡ评分成正相关(P<0.05);由ROC曲线可知,血清sTREM-1、FGF-21、WBC、CRP、PCT联合评估感染性休克患者预后的AUC为0.907,高于五者单独评估的0.737、0.753、0.682、0.637、0.662,差异有统计学意义(P<0.05)。结论感染性休克患者血清sTREM-1、FGF-21、WBC、CRP、PCT水平升高,五者与疾病严重程度有关,联合检测对评估感染性休克患者的预后具有一定临床价值。
Objective To explore the relationship between serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1),fibroblast growth factor-21(FGF-21)and prognosis of patients with septic shock.Methods A total of 97 patients with septic shock admitted to the Wanning People's Hospital were enrolled as the research objects between July 2019 and December 2021.According to 28 d prognosis,they were divided into death group(n=34)and survival group(n=63).A total of 50 healthy controls during the same period were enrolled as control group.The levels of serum sTREM-1,FGF-21,white blood cell count(WBC),C-reactive protein(CRP)and procalcitonin(PCT)in all objects were detected and compared.The scores of sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)in patients with different prognosis were compared.The correlation between serum sTREM-1,FGF-21,WBC,CRP,PCT and SOFA,APACHE Ⅱscores was analyzed by Pearson coefficient.The prognostic values of serum sTREM-1,FGF-21,WBC,CRP and PCT in patients with septic shock were analyzed by receiver operating characteristic(ROC)curves.Results The levels of serum sTREM-1,FGF-21,WBC,CRP and PCT in septic shock group were significantly higher than those in control group,and the differences were statistically significant(t=24.266,31.743,30.236,27.916,28.904,all P<0.05).The levels of serum sTREM-1,FGF-21,WBC,CRP and PCT in death group were significantly higher than those in survival group,and the differences were statistically significant(t=8.518,8.817,7.284,5.060,7.573,all P<0.05).SOFA and APACHE Ⅱscores were significantly higher than those in survival group,the differences were statistically significant(t=7.052,8.143,all P<0.05).The results of Pearson correlation analysis showed that levels of sTREM-1,FGF-21,WBC,CRP and PCT were positively correlated with SOFA and APACHE Ⅱscores(P<0.05).ROC curves analysis showed that AUC of serum sTREM-1 combined with FGF-21,WBC,CRP and PCT for evaluating prognosis of patients with septic shock was 0.907,greater than that of single index(0.737,0.753,0.682,0.637,0.662),and the differences were statistically significant(P<0.05).Conclusions The levels of serum sTREM-1,FGF-21,WBC,CRP and PCT increased in patients with septic shock,which were related to disease severity.Their combined detection had certain clinical evaluation value for prognosis of patients with septic shock.
作者
林海曼
陈耿仟
温江华
LIN Haiman;CHEN Gengqian;WEN Jianghua(Department of Critical Care Medicine,Wanning People's Hospital,Wanning,Hainan 571500,China;Department of Emergency,the First Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570102,China)
出处
《热带医学杂志》
CAS
2023年第8期1075-1079,共5页
Journal of Tropical Medicine
基金
海南省重点研发计划项目(ZDYFXGFY2020007)
