摘要
目的:探讨血清降钙素原变化率、可溶性白细胞介素2受体(sIL-2R)在尿源性脓毒症中的诊断价值.方法:将78例尿源性脓毒症病人作为观察组,同期住院的81例一般泌尿系感染病人作为对照组.采用酶联荧光分析法检测入院时及入院72 h血清降钙素原水平并计算降钙素原变化率,采用酶联免疫吸附法检测入院时血清sIL-2R、C反应蛋白(CRP)水平,采用全自动血液体液分析仪检测白细胞计数(WBC)、中性粒细胞计数、淋巴细胞计数;尿源性脓毒症病人血清sIL-2R、降钙素原变化率与尿路感染常规检测项目的相关性采用Pearson相关分析;采用ROC曲线分析血清sIL-2R、降钙素原变化率对尿源性脓毒症的诊断效能;采用多因素logistic回归分析影响尿源性脓毒症的因素.结果:观察组血清sIL-2R、WBC、CRP、中性粒细胞计数水平显著高于对照组,降钙素原变化率、淋巴细胞计数显著低于对照组(P<0.01).尿源性脓毒症病人血清sIL-2R与降钙素原变化率呈负相关关系(P<0.01);sIL-2R与淋巴细胞计数呈负相关关系(P<0.01),与WBC、CRP、中性粒细胞计数呈正相关关系(P<0.01);降钙素原变化率与淋巴细胞计数呈正相关关系(P<0.01),与WBC、CRP、中性粒细胞计数呈负相关关系(P<0.01).sIL-2R、降钙素原变化率单独及联合诊断尿源性脓毒症的曲线下面积分别为0.849、0.851、0.908,sIL-2R、降钙素原变化率截断值分别为43.51 pg/mL、35.59％.sIL-2R是发生尿源性脓毒症的独立危险因素,降钙素原变化率是发生尿源性脓毒症的保护因素.结论:血清sIL-2R水平联合降钙素原变化率可作为诊断尿源性脓毒症的重要指标.
Abstract
Objective:To investigate the diagnostic value of serum soluble interleukin-2 receptor (sIL-2R) and procalcitonin change rate in urinogenic sepsis.Methods:A tatol of 78 patients with urinary sepsis were set as the observation group,and 81 patients with general urinary tract infection hospitalized at the same period were set as the control group.The serum procalcitonin level at the time of admission and 72 hours after admission was detected by enzyme-linked fluorescence assay,and the procalcitonin change rate was calculated,the levels of serum sIL-2R and C-reactive protein (CRP) on admission were detected by enzyme-linked immunosorbent assay,the white blood cell count (WBC),neutrophil count and lymphocyte count were detected by automatic blood and body fluid analyzer;the correlation between serum sIL-2R,procalcitonin change rate and routine detection items of urinary tract infection in patients with urinogenic sepsis was analyzed by Pearson correlation;ROC curve was applied to analyze the diagnostic efficacy of serum sIL-2R and procalcitonin change rate for urinogenic sepsis;multivariate logistic regression analysis was used to analyze the factors affecting urinogenic sepsis.Results:The serum levels of sIL-2R,WBC,CRP,and neutrophil count in the observation group were significantly higher than those in the control group,while the change rate of procalcitonin and lymphocyte count were significantly lower than those in the control group (P<0.01).There was a negative correlation between serum sIL-2R and the change rate of procalcitonin in patients with urinary sepsis (P<0.01);sIL-2R was negatively correlated with lymphocyte count (P<0.01),and positively correlated with WBC,CRP,and neutrophil count (P<0.01).The change rate of procalcitonin was positively correlated with lymphocyte count (P<0.01),and negatively correlated with WBC,CRP,and neutrophil count (P<0.01).The area under the curve of sIL-2R and the change rate of procalcitonin alone and in combination for the diagnosis of urinary sepsis were 0.849,0.851,and 0.908,respectively.The cutoff values of sIL-2R and the change rate of procalcitonin were 43.51 pg/mL and 35.59％,respectively.SIL-2R was an independent risk factor for the occurrence of urinary sepsis,and the rate of changes in procalcitonin was a protective factor for the occurrence of urinary sepsis.Conclusions:The serum sIL-2R level combined with the procalcitonin change rate can be used as an important indicator for the diagnosis of urinogenic sepsis.
维普
万方数据