摘要
目的 分析不同程度烧伤患者血清细胞间黏附分子-1(ICAM-1)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)变化及预后危险因素.方法 选择2019 年9 月—2022 年3 月收治的烧伤130 例作为观察组,另选取同期60 例健康者作为对照组.比较观察组入院第3、7 天与对照组血清ICAM-1、IL-10、TNF-α,不同程度烧伤患者血清ICAM-1、IL-10、TNF-α;根据患者预后,将观察组又分为生存组和病死组,采用受试者工作特征(ROC)曲线评估血清ICAM-1、IL-10、TNF-α对烧伤患者预后的预测价值;烧伤患者预后影响因素采用多因素Logistic回归分析.结果 观察组入院第3、7 天血清ICAM-1、IL-10、TNF-α高于对照组,且入院第3、7 天血清ICAM-1、IL-10、TNF-α具有差异(P＜0.05).入院第3、7 天,中度组血清ICAM-1、IL-10、TNF-α低于重度组,而重度组低于特重度组;中度组入院后血清ICAM-1、IL-10、TNF-α呈降低趋势,而重度组与特重度组呈增高趋势(P＜0.05).ROC曲线显示,血清ICAM-1、IL-10、TNF-α联合预测烧伤患者预后的曲线下面积(0.826)高于单独预测(0.771、0.783、0.743)(P＜0.05).多因素Logistic回归分析显示,首次乳酸、入院后48h乳酸、机械通气及入院第 3、7 天血清ICAM-1、IL-10、TNF-α为影响烧伤患者预后的危险因素(P＜0.05,P＜0.01).结论 不同程度烧伤患者血清ICAM-1、IL-10、TNF-α具有差异,且三者联合评估烧伤患者预后具有较高价值.首次乳酸、入院后48h乳酸、机械通气及入院第3、7 天血清ICAM-1、IL-10、TNF-α是影响烧伤患者预后的危险因素.
Abstract
Objective To analyze the changes of serum intercellular adhesion molecule-1(ICAM-1),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)levels and prognotic risk factors in patients with different degrees of burn.Methods In total,130 burn patients treated from September 2019 to March 2022 were selected as the observation group,and 60 healthy people during the same period were selected as the control group.The levels of serum ICAM-1,IL-10 and TNF-α were compared between the observation group and the control group at 3 and 7 d after admission,and the levels of serum ICAM-1,IL-10 and TNF-α in patients with different degrees of burn were compared.According to the prognosis,the observa-tion group was subdivided into survival subgroup and mortality subgroup.The predictive value of serum ICAM-1,IL-10 and TNF-α for the prognosis of burn patients was evaluated by receiver operating characteristic(ROC)curve.Multivariate Logistic regression analysis was used to analyze the prognostic factors of burn patients.Results The levels of serum ICAM-1,IL-10 and TNF-α in the observation group were significantly higher than those in the control group at 3 and 7 d after admission,and the levels of serum ICAM-1,IL-10 and TNF-α were significantly different at 3 and 7 d after admission(P＜0.05).The levels of serum ICAM-1,IL-10 and TNF-α in moderate group were significantly lower than those in severe group,which were signifi-cantly lower in severe group than in extremely severe group(P＜0.05).The levels of serum ICAM-1,IL-10 and TNF-α in moderate group were decreased after admission,while those in severe group and extremely severe group were increased(P＜0.05).ROC curve results showed that the area under the ROC curve of ICAM-1,IL-10 and TNF-α in combination(0.826)in predicting prognosis of burn patients was higher than that of ICAM-1,IL-10 and TNF-αin prediction alone(0.771,0.783,0.743)(P＜0.05).Multivariate Logistic regression analysis showed that lactic acid for the first time,lactic acid at 48 h after admission,mechanical ventilation,and serum ICAM-1,IL-10 and TNF-α at 3 and 7 d after admission were the risk factors for the prognosis of burn patients(P＜0.05,P＜0.01).Conclusion Serum ICAM-1,IL-10 and TNF-α have significant differ-ences in patients with different degrees of burn,and the combined detection of the three has high application value in evalua-ting the prognosis of burn patients.In addition,lactic acid for the first time,lactic acid at 48 h after admission,mechanical ventilation and serum ICAM-1,IL-10 and TNF-α at 3 and 7 d after admission were risk factors affecting the prognosis of burn patients.
基金项目
河北省医学科学研究项目(2022)(20221883)
张家口市科技局重点研发计划(2022)(2221098D)
国家科技期刊平台
NSTL
维普
万方数据