Study on the Relationship between Serum PCT,APOM,sTREM-1 and Prognosis in Patients with Sepsis Due to Bacterial Bloodstream Infection
Objective:To investigate the relationship between serum procalcitonin(PCT),apolipoprotein M(APOM),soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and prognosis in patients with sepsis due to bacterial bloodstream infection(BSI).Methods:185 patients with sepsis due to bacterial BSI(sepsis group)were selected in Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2021 to October 2023,patients were divided into death group(61 cases)and survival group(124 cases)according to the prognosis within 28 days,and 87 healthy volunteers(control group)were selected from our hospital during the same period.Serum PCT level was detected by electrochemiluminescence,and serum APOM and sTREM-1 levels were detected by enzyme-linked immunosorbent assay.The factors affecting the prognosis of patients with sepsis due to bacterial BSI were analyzed by univariate and multivariate Logistic regression models.The predictive value of serum PCT,APOM and sTREM-1 on the prognosis of patients with sepsis due to bacterial BSI were analyzed by receiver operating characteristic(ROC)curve.Results:Compared with control group,the levels of serum PCT and sTREM-1 in sepsis group were increased,and the level of APOM was decreased(P＜0.05).The 28-day mortality rate of 185 patients with sepsis due to bacterial BSI was 32.97％(61/185).Compared with survival group,the levels of serum PCT and sTREM-1 in death group increased,and the level of APOM decreased(P＜0.05).The results of the multifactor analysis show that gram-negative bacterial infection,septic shock,increased neutrophil/lymphocyte ratio(NLR),increased sequential organ failure assessment(SOFA)score,increased acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,increased serum PCT and sTREM-1 were independent risk factors for death in patients with sepsis due to bacterial BSI,and increased serum APOM was an independent protective factor(P＜0.05).The area under the curve of combined detection of serum PCT,APOM and sTREM-1 in predicting the death of patients with sepsis due to bacterial BSI was 0.908,which was greater than 0.785,0.779 and 0.783 predicted by serum PCT,APOM and sTREM-1 alone.Conclusion:The increase of serum PCT and sTREM-1 levels and the decrease of APOM level in patients with sepsis due to bacterial BSI are relate to the occurrence of poor prognosis,the combine detection of serum PCT,APOM and sTREM-1 has a high predictive value for the death of patients with sepsis due to bacterial BSI.
Bacterial bloodstream infectionSepsisProcalcitoninApolipoprotein MSoluble triggering receptor expressed on myeloid cells-1Prognosis
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