Analysis of changes in blood SAA,sTREM-1,NLR,PGRN and prognostic factors in children with sepsis
Objective To analyze the changes of serum amyloid protein(SAA),soluble myeloid cell trigger receptor-1(sTREM-1),neutrophil to lymphocyte ratio(NLR),and progranulin(PGRN)in children with sepsis,and to analyze the related prognostic influencing factors.Methods 120 children with sepsis admitted to our hospital from January 2019 to December 2022 were selected as the observation group,and 46 healthy children without sepsis in the same period were matched as the health group.The children in the observation group were divided into the survival group(94 cases)and the death or abandonment of treatment group(26 cases)according to their 28-d survival and death,and the levels of SAA,sTREM-1,NLR,and PGRN were compared between the septic children and the healthy newborns.Binary logistic regression was used to analyze the factors affecting the prognosis of children with sepsis,and receiver operating characteristic(ROC)curves were established to assess the value of SAA,sTREM-1,NLR,and PGRN in predicting developmental outcomes.Result Compared with the healthy group,the levels of SAA,sTREM-1,and NLR in the observation group were significantly higher,while PGRN was significantly lower,with a statistically significant difference(t=44.598,7.137,7.141,-1 6.695,respectively,P＜0.05).Compared with the survival group,children in the death or abandonment of treatment group had higher admission heart rate,admission respiratory rate,percentage of gestational age ≤28 weeks,higher levels of SAA,sTREM-1,and NLR,and lower levels of PGRN,and admission oxygen saturation,and the differences were statistically significant(x2/t=-5.388-9.038,P＜0.05).Multifactorial logistic regression analysis showed that admission heart rate,SAA,sTREM-1,and NLR were risk factors affecting the prognosis of children with sepsis,with ORs and 95％CIs of 1.534(1.203-1.955),1.037(1.017-1.058),1.255(1.052-1.496),1.755(1.228-2.507),and oxygen saturation and PGRN were protective factors affecting the prognosis of children with sepsis,with ORs and 95％CIs of 0.282(0.142-0.560)and 0.926(0.884-0.970),respectively.The area under the curve(AUC)of SAA,sTREM-1,NLR,and PGRN for predicting the developmental outcome of children with sepsis was 0.804,0.718,0.873,and 0.780,respectively,and the AUC for the combined prediction was 0.928.Conclusion Abnormally elevated blood SAA,sTREM-1,and NLR in children with sepsis compared to healthy children are risk factors for prognosis.Abnormally reduced PGRN levels are protective factors for prognosis.
sepsissoluble myeloid cell trigger receptor-1serum amyloid proteinneutrophil to lymphocyte ratioprogranulinprognosis
万方数据
维普
