摘要
目的:检测脓毒性休克患者血清淀粉样蛋白A(SAA)水平,并进行快速序贯器官衰竭评分(qSOFA)评分评定,探讨SAA结合qSOFA对脓毒性休克的预测价值。方法:选取2017-05-2019-05期间本院收治的脓毒症患者253例(观察组)为研究对象,其中,非脓毒性休克患者147例(非休克组),脓毒性休克患者106例(休克组);并根据28 d内是否病死再将休克组患者分为生存组(60例)和死亡组(46例)。选取同期正常体检者255例为对照组。采集清晨外周血提取血清,酶联免疫(ELISA)法检测研究对象SAA水平,并进行qSOFA评分评定。采用受试者工作特征(ROC)曲线评估血清SAA水平和qSOFA评分对脓毒性休克的诊断价值和预后价值。结果:观察组脓毒症患者血清SAA水平和qSOFA评分与对照组相比均明显升高(P<0.05);休克组血清SAA水平和qSOFA评分与非休克组相比均明显升高(P<0.05);死亡组血清SAA水平和qSOFA评分与生存组相比均明显升高(P<0.05);两者联合诊断脓毒性休克发生的ROC曲线下面积为0.905(95%CI:0.866~0.945),敏感度为78.3%,特异度为91.8%;联合预后脓毒性休克患者死亡的ROC曲线下面积为0.916(95%CI:0.865~0.967),敏感度为87.0%,特异度为81.7%。结论:脓毒性休克患者血清SAA水平和qSOFA评分均明显升高,联合检测对脓毒性休克有较高诊断价值和预后价值,可用作临床参考。
Objective:To detect the level of serum amyloid A(SAA)in patients with septic shock,and to evaluate the value of combination of SAA and rapid sequential organ failure assessment(qSOFA)score in the prediction of septic shock.Method:Two-hundred and fifty-three patients with sepsis(observation group)admitted to our hospital from May 2017 to May 2019 were selected as the study subjects,including 147 patients with non-septic shock(non-shock group)and 106 patients with septic shock(shock group).According to whether they died within 28 days,septic shock patients were divided into survival group(60 cases)and death group(46 cases).Two-hundred and fifty-five healthy persons in the same period were selected as control group.Serum was collected from peripheral blood in the morning,and the SAA level was detected by enzyme-linked immunosorbent assay(ELISA),and the qSOFA score was evaluated.The diagnostic and prognostic values of serum SAA level and qSOFA score for septic shock were evaluated by ROC curve.Result:The serum SAA level and qSOFA score in the observation group were significantly higher than those in the control group(P<0.05);serum SAA level and qSOFA score in shock group were significantly higher than those in non-shock group(P<0.05);the serum SAA level and qSOFA score in the death group were significantly higher than those in the survival group(P<0.05);the area under ROC curve of combination in diagnosing septic shock was 0.905(95%CI:0.866-0.945),the sensitivity was 78.3%,and the specificity was 91.8%;the area under ROC curve of combination in diagnosing death in septic shock was 0.916(95%CI:0.865-0.967),the sensitivity was 87.0%,and the specificity was 81.7%.Conclusion:Serum SAA level and qSOFA score in patients with septic shock are significantly increased.Combined detection of Serum SAA level and qSOFA score has high diagnostic value and prognostic value for septic shock,and it can be used for clinical practice.
作者
张琼
梁哲
苑艺
付淼
李鹏
葛振宇
于敏敏
ZHANG Qiong;LIANG Zhe;YUAN Yi;FU Miao;LI Peng;GE Zhenyu;YU Minmin(Department of Emergency,Baoji Central Hospital,Baoji,Shaanxi,721008,China)
出处
《临床急诊杂志》
CAS
2019年第12期971-975,共5页
Journal of Clinical Emergency
