摘要
目的:探讨补体C1q肿瘤坏死因子相关蛋白1(CTRP1)与脓毒症患者严重程度及短期预后的相关性。方法:连续入选住院的脓毒症患者146例,根据有无休克发生将患者分为休克组(91例)和非休克组(55例),根据出院后30d是否存活将患者分为存活组(104例)和死亡组(42例)。应用酶联免疫吸附法(ELISA)测定血清CTRP1水平。采用ROC曲线和COX回归分析CTRP1对脓毒症患者严重程度和短期预后的相关性。结果:与无休克组相比较,休克组MAP、血乳酸、PCT、CTRP1水平均明显升高,两组间差异有统计学意义(P<0.01);死亡组的MAP、肌钙蛋白T及CTRP1水平与存活组的相比较,差异有统计学意义(P<0.01)。多因素COX分析,在校正MAP、肌钙蛋白T、PCT等因素后,CTRP1仍然是影响脓毒症患者短期预后的独立影响因素(HR2.17,95%CI:1.72～2.86,P<0.01)。采用ROC曲线,分析PCT及CTRP1对脓毒症患出院后30d死亡的预测价值,显示CTPR1曲线下面积(AUC:0.87,95%CI:0.74～0.93,P<0.01;敏感度为89.5%,特异度为74.4%)大于PCT曲线面积(AUC:0.80,95%CI:0.76～0.91,P<0.01;敏感度为87.2%,特异度为77.1%)。结论:CTRP1与脓毒症患者严重程度具有相关性。CTRP1对脓毒症患者的短期死亡具有预测价值,CTRP1可与PCT等传统危险因素一起对脓毒症患者的严重程度和预后进行评估。
Objective:To investigate the correlation between complement C1 q tumor necrosis factor-related protein 1(CTRP1)and short-term prognosis in sepsis patients.Method:One hundred and forty-six cases of hospitalized sepsis were consecutively selected,and the patients were divided into shock group(55cases)and non-shock group(91cases).The patients were divided into survival group(104cases)and death group(42cases)on the basis of survival 30 days after discharge.The correlation between CTRP1 and short-term prognosis was analyzed by ROC curve and COX regression.Result:Compared with non-shock group,the levels of MAP,blood lactate,PCT and CTRP1 in shock group were significantly higher(P<0.01);the levels of MAP,troponin T and CTRP1 in death group were significantly higher than those in survival group(P<0.01).Multivariate COX analysis showed that CTRP1 was still an independent factor influencing short-term prognosis of sepsis patients after adjusting for factors such as MAP,troponin T and PCT(HR 2.17,95%CI:1.72—2.86,P<0.01).The ROC curve was used to analyze the predictive value of PCT and CTRP1 for 30dead sepsis patients after discharge.The area under CTPR1curve(AUC:0.87,95%CI:0.74—0.93,P<0.01;sensitivity 89.5%,specificity 74.4%)was larger than that under PCT curve(AUC:0.80,95%CI:0.76—0.91,P <0.01;sensitivity 87.2%,specificity 77.1%).Conclusion:CTRP1is associated with the severity of sepsis.In addition,CTRP1 has a predictive value for the short-term death of patients with sepsis,and CTRP1 can be used to assess the severity and prognosis of septic patients with the traditional risk factors such as PCT.
作者
曾志友
杜贵鹏
廖舒
ZENG Zhiyou;DU Guipeng;LIAO Shu(Department of Intensive Care Unit,the Second Affiliated Hospital of Chengdu Medical College,Chengdu,610051,China)
出处
《临床急诊杂志》
CAS
2019年第2期128-132,共5页
Journal of Clinical Emergency
