Changes in serum endotoxin,PCT and BNP in patients with sepsis infected by extensively drug resistant Gram-negative bacteria and their relationship with prognosis
Objective To explore the levels of serum endotoxin,procalcitonin(PCT)and B-type natriuretic peptide(BNP)and their relationship with prognosis in patients with extensively drug resistant Gram-negative bacteria(XDR-GNB)infection and sepsis.Methods A retrospective collection was performed on the data of patients with XDR-GNB infection and sepsis admitted to the People's Hospital of Wanning between October 2019 and October 2022.According to 28 d prognosis,they were divided into survival group(n=166)and death group(n=92).The levels of serum endotoxin,PCT and BNP,scores of sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)were compared between the two groups,and clinical evaluation value of the above indexes for prognosis was analyzed by receiver operating characteristic(ROC)curves.Results The levels of serum endotoxin,PCT,BNP,SOFA,APACHE Ⅱ were in the death group were(26.32±3.34)μg/mL,(5.93±1.21)ng/mL,(368.49±65.28)μg/mL,(14.35±3.27)score,(33.56±5.71)score,which were lower than that in the survival group[(16.57±2.71)μg/mL,(3.68±0.91)ng/mL,(176.35±56.30)μg/mL,(9.42±3.04)score,(26.20±4.18)score],the differences were statistically significant(t=23.244,15.304,22.774,11.233,10.726,all P＜0.05).Logistic regression analysis showed that serum endotoxin(OR=1.684,95％CI:1.077-2.632),PCT(OR=5.737,95％CI:1.080-30.475),BNP(OR=1.033,95％CI:1.001-1.065)and APACHE Ⅱscore(OR=1.327,95％CI:1.005-1.753)were all risk factors of death(all P＜0.05).Area under curve(AUC)values of serum endotoxin,PCT,BNP and APACHE Ⅱ score for predicting 28 d death were 0.869,0.883,0.921 and 0.885,respectively(all P＜0.01).The levels of serum endotoxin,PCT and BNP were positively correlated with APACHE Ⅱ score(r=0.394,0.415,0.463;all P＜0.001).Conclusion Serum endotoxin,PCT and BNP could be used as indicators to predict prognosis of patients with XDR-GNB infection and sepsis,which were correlated with APACHE Ⅱ score and could reflect patients'condition to a certain extent.
Extensively drug resistantGram-negative bacteriaSepsisEndotoxinProcalcitoninB-type natriuretic peptidePrognosis
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