摘要
目的 研究血清降钙素原(PCT)、淀粉样蛋白A(SAA)及前白蛋白A(PA)水平与脓毒症患者病情严重程度及病原微生物感染类型的相关性。方法 选择2019年6月-2021年6月上海建工医院收治的80例脓毒症患者为研究对象。采用微生物鉴定与分析系统监测全部患者病原微生物感染类型,并按照感染类型分为两组,即细菌感染组(n=53)和真菌感染组(n=27)。采用免疫比浊法测定两组患者血清SAA和PA水平,通过双抗夹心免疫荧光发光法测定PCT水平,结合ROC曲线分析血清PCT、SAA及PA水平与脓毒症患者病原微生物感染类型、疾病严重程度的相关性。结果 细菌感染组PCT、SAA水平高于真菌感染组,PA水平低于真菌感染组,差异有统计学意义(t=-8.793、-7.658、11.620,P<0.05)。一般脓毒症组PCT、SAA水平低于严重脓毒症组,PA水平高于严重脓毒症组,差异有统计学意义(t=-7.234、-8.461、8.570,P<0.05)。ROC曲线分析结果显示,PCT、SAA、PA诊断脓毒症患者感染类型的AUC分别为0.853、0.864、0.797,差异有统计学意义(P<0.05)。PCT、SAA、PA诊断脓毒症患者严重程度的AUC分别为0.809、0.806、0.729,差异有统计学意义(P<0.05)。结论 血清PCT、SAA及PA表达水平可有效反映脓毒症患者疾病进展,且与其病原微生物感染类型密切相关,SAA、PCT指标分别可作为鉴别其感染类型及诊断疾病程度的重要指标,可根据该结果为患者制定针对性的治疗方案。
Objective To investigate the correlation between serum procalcitonin(PCT),serum amyloid A(SAA)and prealbumin(PA)levels and the severity of sepsis and the types of pathogenic microbial infection in patients with sepsis.Methods 80 patients with sepsis from June 2019 to June 2021 were selected.The pathogenic microbial infection types in all patients were monitored by a microbial identification and analysis system,and divided into two groups according to the infection types,namely,a bacterial infection group(53 cases)and a fungal infection group(27 cases).The serum levels of SAA and PA in two groups were determined by nephelometry.The PCT level was determined by double antibody sandwich immunofluorescence spectrophotometry.In addition,the receiver operating curve(ROC)was used to analyze the correlation between the serum levels of PCT,SAA and PA and the type of pathogenic microbial infection and disease severity in sepsis patients.Results The levels of PCT and SAA in the bacterial infection group were higher than those in the fungal infection group,and the level of PA was lower than that in the fungal infection group,the difference was statistically significant(t=-8.793,-7.658,11.620,P<0.05).The levels of PCT and SAA in the general sepsis group were lower than those in the severe sepsis group,and the level of PA was higher than that in the severe sepsis group(t=-7.234,-8.461,8.570,P<0.05).The results of ROC curve analysis showed that the AUC of PCT,SAA and PA in the diagnosis of infection type in sepsis patients was 0.853,0.864 and 0.797,respectively,the difference was statistically significant(P<0.05).The AUC values of PCT,SAA,and PA in the diagnosis of severity in sepsis patients were 0.809,0.806,and 0.729,respectively,the difference was statistically significant(P<0.05).Conclusions The expression levels of serum PCT,SAA and PA could effectively reflect the disease progression of sepsis patients and were closely related to the type of pathogenic microorganism infection.The indicators of SAA and PCT could be used as important indicators to identify the type of infection and diagnose the degree of disease,respectively,which could be used to formulate targeted treatment plan for patients based on the results.
作者
李洺
陈慧琳
严姝瑛
徐华娟
LI Ming;CHEN Hui-lin;YAN Shu-ying;XU Hua-juan(Intensive Care Unit of Shanghai Jiangong Hospital,Shanghai 200083,China)
出处
《热带医学杂志》
CAS
2022年第2期226-229,共4页
Journal of Tropical Medicine
基金
上海市卫生和计划生育委员会科研项目(201840263)。
