Objective To investigate the clinical value of serum levels of growth differentiation factor 15(GDF-15),fibroblast growth factor 21(FGF-21)in the and the evaluation and prognosis of patients with sepsis.Methods A retrospective study was conducted on 102 pa-tients with sepsis admitted to the ICU of the Affiliated Hospital of Chengde Medical College from January 2020 to June 2023.According to the cri-teria of Sepsis-3,the patients were divided into the sepsis group(n=46)and the septic shock group(n=56)according to the different ell-ness.The patients were divided into the survival group(n=75)and the death group(n=27)according to the 28-day prognosis.The routine clinical data of patients were collected,including gender,age,white blood cell count(WBC),D-dimer,lymphocyte(LY)count,and acute physiology and chronic health status evaluation Ⅱ(APACHE Ⅱ)score at 24 h after admission.The clinical data,serum GDF-15 and FGF-21 levels in different groups were compared,and the relationship between GDF-15 and FGF-21 and APACHE Ⅱ score was analyzed.The pre-dictive value of GDF-15 and FGF-21 for 28-day death was evaluate using receiver operating characteristic(ROC)curve.Results There was no significant difference in sex ratio,age and LY between sepsis group and septic shock group(P＞0.05).The levels of WBC,D-dimer,APACHE Ⅱ score,GDF-15 and FGF-21 in septic shock group were higher than those in sepsis group,and the 28-day mortality was higher than that in sepsis group,the differences were statistically significant(P＜0.05).There was no significant difference in sex ratio,age and LY between the death group and the survival group(P＞0.05).The WBC,D-dimer,APACHE Ⅱ score,serum GDF-15 and FGF-21 levels in the death group were higher than those in the survival group,and the differences were statistically significant(P＜0.05).Pearson correlation a-nalysis showed that serum GDF-15 and FGF-21 levels were positively correlated with APACHE Ⅱ score in patients with sepsis(r=0.378,0.394;P＜0.001).Logistic regression analysis showed that serum GDF-15 level(OR=1.169,95％CI:1.041-1.312),FGF-21 water(OR=1.406,95％CI:1.129-1.752)and APACHE Ⅱ score(OR=1.346,95％CI:1.095-1.653)were risk factors for 28-day death in patients with sepsis(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum GDF-15 and FGF-21 in pre-dicting 28-day death in patients with sepsis were 0.888 and 0.820,respectively,and there was no significant difference compared with APACHEⅡ score(AUC=0.867)(P＞0.05).Conclusion The increase of serum GDF-15 and FGF-21 levels is related to the severity of sepsis and has a certain predictive ability for the prognosis of patients.
维普
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