肝素结合蛋白联合白介素-6对脓毒症预后的预测价值
Integration of heparin-binding protein and interleukin-6 in the early prediction of mortality in sepsis
蒙钰铭 1贾亚娟 1高志伟 1高素敏 1孙虹1
作者信息
- 1. 南京医科大学附属淮安第一医院急诊医学科(南京,530022)
- 折叠
摘要
目的:探讨肝素结合蛋白(heparin-binding protein,HBP)联合白细胞介素-6(interleukin-6,IL-6)对脓毒症预后的预测价值.方法:采用回顾性研究方法,选取2021年9月—2023年5月期间南京医科大学附属淮安第一医院急诊医学科收治的符合Sepsis 3.0诊断标准的119例脓毒症患者,根据患者预后分为生存组和死亡组.分析比较两组患者临床资料,采用多因素Cox回归分析HBP、IL-6对患者预后的影响,绘制森林图比较患者预后的独立危险因素差异.对不同HBP、IL-6水平患者进行Kaplan-Meier(K-M)生存分析.结果:与生存组相比,死亡组患者HBP、IL-6水平明显升高.Cox回归分析显示HBP＞161.77 ng/mL(HR=4.850,95％CI:1.918～12.260,P＜0.001)、IL-6＞119.11 pg/mL(HR=4.208,95％CI:1.321～13.410,P=0.015)是患者住院死亡的独立危险因素.K-M生存分析显示当HBP＞161.77 ng/mL且IL-6＞119.11 pg/mL时,患者住院死亡风险升高,差异有统计学意义(HR=7.87,95％CI:3.23～19.18,P＜0.000 1).HBP联合IL-6预测脓毒症预后的灵敏度为66.7％,特异度为93.3％,阳性预测值为77.1％,阴性预测值为89.3％,阳性似然比为9.96,阴性似然比为0.36.结论:HBP和IL-6是脓毒症预后的独立危险因素,两者联合对脓毒症预后有较好的预测价值.
Abstract
Objective:To investigate the predictive value of heparin-binding protein(HBP)and interleukin-6(IL-6)in sepsis.Methods:A total of 119 adult patients with sepsis were enrolled in this retrospective study who admitted to Department of Emergency Medicine of the Affiliated Huaian No.1 People's Hospital of Nanjing Medi-cal University from September 2021 to May 2023.They were divided into survival group and death group accord-ing to survival status.HBP,IL-6 and other clinical data of two groups were analyzed and compared.Multivariate Cox regression were used to analyze the influence of HBP and IL-6 on prognosis,and forest plots were drawn to compare the independent prognostic factors.Kaplan-Meier(K-M)survival analysis was performed for patients.Re-sults:The HBP and IL-6 of the death group was significantly higher than those of the survival group(P＜0.05).Cox regression analysis evidenced admission HBP more than 161.77 ng/mL(HR=4.850,95％CI:1.918-12.260,P＜0.001)and IL-6 more than 119.11 pg/mL(HR=4.208,95％CI:1.321-13.410,P=0.015)as independent risk factors for hospitalization motality of patients with sepsis.K-M survival analysis showed that hospitalization motality risk of patients with HBP＞161.77 ng/mL and IL-6＞119.11 pg/mL was higher(HR:7.87,95％CI:3.23-19.18,P＜0.000 1).Integration of HBP and IL-6 prognosticated mortality with sensitivi-ty,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio 66.7％,93.3％,77.1％,89.3％,9.96,0.36,respectively.Conclusion:The levels of HBP and IL-6 are in-dependent risk factors for sepsis patients.And the integration of the two had good predictive value for prognosis of sepsis patients.
关键词
肝素结合蛋白/白细胞介素-6/脓毒症/预后Key words
heparin-binding protein/interleukin-6/sepsis/prognosis引用本文复制引用
出版年
2024
NETL
NSTL
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