Value of combined detection of plasma MIP-1 α,FIB,and LTB4 in predicting the prognosis of patients undergoing massive blood transfusion in ICU
Objective To investigate the prognostic value of combined detection of plasma fibrinogen(FIB),chemokine macrophage inflammatory protein-1α(MIP-1α),and leukotriene B4(LTB4)in predicting the prognosis of patients undergoing massive blood transfusion in Intensive Care Unit(ICU).Methods A retrospective analysis was conducted on the clinical data of 141 ICU patients who underwent massive blood transfusion and were admitted to Zhu-madian Central Hospital from January 2022 to January 2024.Patients were divided into the poor prognosis group(n=46)and the good prognosis group(n=95)according to the 3-month follow-up outcomes.The general information and plas-ma MIP-1α,FIB,and LTB4 expression levels of the two groups of patients were compared.Pearson correlation coeffi-cients were calculated to analyze the correlation between plasma indicators and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores and Injury Severity Score(ISS)scores.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the predictive efficacy of plasma indicators for predicting the prognosis of patients undergoing massive blood transfusion in ICU.The AUC size was analyzed using the Delong test,and the relative risk(RR)was used to analyze the prognosis of patients with different plasma MIP-1α,FIB,and LTB4 expression levels.Results The APACHE Ⅱ and ISS scores of patients in the poor prognosis group were(19.18±1.56)points and(18.20±1.33)points,respectively,which were higher than(15.52±1.30)points and(15.11±1.24)points of patients in the good prognosis group,respectively,with statistically significant differences(P<0.05).The MIP-1α and LTB4 levels in patients with poor prognosis were(90.94±18.18)pg/mL and(22.24±6.68)pg/mL,respectively,which were higher than(75.52±13.21)pg/mL and(15.26±4.58)pg/mL in patients with good prognosis(P<0.05).Meanwhile,the FIB level in patients with poor prognosis was(1.40±0.42)g/L,which was significantly lower than(1.85±0.55)g/L in patients with good prognosis(P<0.05).Pearson analysis showed that the expression levels of MIP-1α and LTB4 in pa-tients with poor prognosis were positively correlated with APACHE Ⅱ and ISS scores(r=0.602,0.598,0.623,0.617,re-spectively,P<0.05),while the expression levels of FIB were negatively correlated with APACHE Ⅱ and ISS scores(r=-0.576,-0.605,respectively,P<0.05).ROC curve analysis revealed that the combined detection of MIP-1α,FIB,and LTB4 had greater predictive value for poor prognosis in patients undergoing massive transfusion compared to single pre-dictor(P<0.001).RR analysis results indicated that patients with high levels of MIP-1α and LTB4 had a 3.166-fold and 5.385-fold higher risk of poor prognosis,respectively,compared to those with low values,and patients with low FIB lev-els had a 4.188-fold higher risk of poor prognosis compared to those with high levels.Conclusion The abnormal ex-pression levels of plasma MIP-1α,FIB,and LTB4 are closely related to the severity and prognosis of patients with mas-sive blood transfusion in ICU,and the combined detection of MIP-1α,FIB,and LTB4 can serve as an auxiliary method to predict poor prognosis in these patients.
Chemokine macrophage inflammatory protein-1 αFibrinogenLeukotriene B4Intensive Care UnitBlood transfusionPrognosis
万方数据
维普
