首页|脓毒症患者血清VitD、FRT、HB-EGF表达情况与预后预测价值探讨

脓毒症患者血清VitD、FRT、HB-EGF表达情况与预后预测价值探讨

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目的 探讨分析脓毒症患者血清维生素D(VitD)、铁蛋白(FRT)、肝素结合性表皮生长因子(HB-EGF)表达情况与预后预测价值.方法 选取2021年1月-2022年1月某院重症监护病房收治的86例脓毒症患者作为病例组,并选择重症监护病房中60例非脓毒症患者作为对照组.根据脓毒症患者1个月后预后情况,将患者分为存活组和死亡组.入院时采集患者血清,检测血清VitD、FRT、HB-EGF水平,分析其表达水平与脓毒症患者预后的相关性,并采用受试者工作特征曲线下面积(AUC)评估其对预后的预测价值.结果 病例组脓毒症患者白细胞计数、C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子(TNF-α)、白细胞介素(IL)-6、IL-1β、FRT水平高于对照组非脓毒症患者,VitD、HB-EGF水平低于对照组非脓毒症患者,差异均有统计学意义(均P<0.05).随访脓毒症患者1个月后预后情况,55例存活,31例死亡.死亡组患者APACHE Ⅱ评分、SOFA评分、PCT、TNF-α、IL-1β、FRT高于存活组患者,而VitD、HB-EGF低于存活组患者,差异均有统计学意义(均P<0.05).Pearson相关性分析结果显示,VitD与APACHE Ⅱ评分、SOFA评分、白细胞计数、CRP、PCT、TNF-α呈负相关关系(均P<0.05);HB-EGF 与 APACHE Ⅱ 评分、CRP、PCT、TNF-α、IL-6、IL-1β 呈负相关关系(均 P<0.05);FRT 与 APACHE Ⅱ 评分、CRP、PCT、TNF-α、IL-6、IL-1β呈正相关关系(均P<0.05).血清VitD、FRT、HB-EGF联合检测预测脓毒症患者预后的AUC为0.82(95%CI:0.72~0.86),灵敏度为84.39%,特异度为69.35%.结论 脓毒症患者血清VitD、HB-EGF水平较低,FRT水平较高,其表达水平与患者预后密切相关,对预测脓毒症患者预后具有较好预测价值.
Expression and prognostic value of serum VitD,FRT and HB-EGF in sep-sis patients
Objective To explore and analyze the expression and prognostic value of serum vitamin D(VitD),fer-ritin(FRT)and heparin-binding epidermal growth factor(HB-EGF)in sepsis patients.Methods 86 sepsis patients who were admitted to the intensive care unit(ICU)of a hospital from January 2021 to January 2022 were selected as the case group,and 60 non-sepsis patients in the ICU were selected as the control group.According to the prognosis of sepsis patients one month later,patients were divided into survival group and death group.Patient's serum upon admission was taken,levels of serum VitD,FRT and HB-EGF were detected,the correlation with the prognosis of sepsis patients was analyzed,and the prognostic value was evaluated by area under curve(AUC)of receiver opera-ting characteristic curve.Results Levels of white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1β and FRT of case group were all higher than those of non-sepsis patients in the control group,while the VitD and HB-EGF levels were lower than those of non-sepsis patients in the control group,differences were all statistically significant(all P<0.05).One month follow-up on the prognosis of sepsis patients showed that 55 patients survived and 31 died.Acute physiology and chronic health evaluationⅡ(APACHE IⅡ)score,sequential organ failure assessment(SOFA)score,PCT,TNF-α,L-1βand FRT score in patients in the death group were all higher than those in patients in the survival group,while VitD and HB-EGF were lower than patients in the survival group,differences were all statistically significant(all P<0.05).The Pearson correlation analysis results showed that VitD were negatively correlated with APACHE Ⅱ score,SOFA score,WBC,CRP,PCT and TNF-α(all P<0.05),HB-EGF was negatively correlected with APACHE Ⅱ,score,CRP,PCT,TNF-α,IL-6 and IL-1β(all P<0.05);while FRT was positively correlated with APACHE Ⅱscores,CRP,PCT,TNF-α,IL-6 and IL-1β(all P<0.05).The AUC,sensitivity,and specificity of combined de-tection of serum VitD,FRT and HB-EGF in predicting the prognosis of sepsis patients were 0.82(95%CI:0.72-0.86),84.39%,and 69.35%,respectively.Conclusion Serum levels of VitD and HB-EGF are lower and FRT is higher in sepsis patients,their expression levels are closely related to patient prognosis,and have good predictive value for predicting the prognosis of sepsis patients.

sepsisvitamin Dferritinheparin-binding epidermal growth factorprognosisROC curve

唐宁、汤展宏、易其琼

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广西壮族自治区南宁市武鸣区中医医院重症医学科,广西南宁 530199

广西医科大学第一附属医院重症医学科,广西 南宁 530021

脓毒症 维生素D 铁蛋白 肝素结合性表皮生长因子 预后 ROC曲线

国家自然科学基金项目国家临床重点专科建设项目

8196034220115245

2024

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子:2.112
ISSN:1671-9638
年,卷(期):2024.23(2)
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