首页|钙卫蛋白对外科术后脓毒症患者的早期诊断价值

钙卫蛋白对外科术后脓毒症患者的早期诊断价值

Calprotectin as an early diagnostic marker for sepsis in post-operative patients

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目的:本研究拟检测外科术后脓毒症患者血浆钙卫蛋白含量,阐明钙卫蛋白对脓毒症的早期诊断价值。方法:前瞻性纳入外科术后转入重症医学科的成人患者205例,其中男性151例,女性54例;年龄24~95岁,平均(64.68±14.46)岁。按照患者在ICU期间是否发生脓毒症,将入组患者分为脓毒症组与非脓毒症组,其中脓毒症组100例,非脓毒症组105例。收集所有患者入ICU 24 h内的静脉血标本,收集脓毒症组患者确诊脓毒症24 h内的静脉血标本,并测定血浆钙卫蛋白及其他感染相关指标水平。通过单因素及多因素Logistic回归分析,确定发生脓毒症的危险因素。在此基础上绘制钙卫蛋白诊断脓毒症的ROC曲线,评价其对脓毒症的诊断价值。结果:与非脓毒症组相比,脓毒症组患者血钙卫蛋白、降钙素原(PCT)水平明显升高(P<0.01)。多因素Logistic回归分析显示,入组当天最高SOFA评分、急诊手术、糖尿病、血钙卫蛋白、PCT、白细胞计数是术后发生脓毒症的独立危险因素。钙卫蛋白诊断术后发生脓毒症的AUC为0.81(95%CI 0.75,0.86),PCT诊断术后发生脓毒症的AUC为0.78(95%CI 0.71,0.84),钙卫蛋白联合PCT诊断术后发生脓毒症的AUC为0.87(95%CI 0.81,0.92)。结论:外科术后患者血浆钙卫蛋白水平对脓毒症有诊断价值,且与PCT联合时早期诊断价值更高。
Objective:To investigate the diagnostic value of calprotectin for sepsis.Methods:We prospectively enrolled adult patients who were transferred to intensive care unit(ICU)after surgery.205 patients after surgery were included in this study. There were 100 patients in the sepsis group and 105 patients in the non-sepsis group. Venous blood samples were collected from all patients within 24 hours after admission to ICU. We also collected venous blood samples from patients in the sepsis group within 24 hours after diagnosis of sepsis. Then calprotectin levels were measured. We compared baseline data and laboratory indexes between the two groups immediately after enrollment. Risk factors of sepsis were evaluated by univariate and multivariate Logistic regression analysis. We drew ROC curve of calprotectin for sepsis diagnosis to evaluate its diagnostic value.Results:The sepsis group had significantly higher serum levels of calprotectin and PCT than the non-sepsis group(P<0.01). Multivariate logistic regression analysis revealed that SOFA score, emergency surgery, diabetes, serum calprotectin, PCT and white blood cell were independent risk factors for sepsis after major surgery. The AUC of calprotectin for diagnosing sepsis after major surgery was 0.81(95% CI 0.75, 0.86), and that of PCT was 0.78(95% CI 0.71, 0.84). The AUC of calprotectin combined with PCT for diagnosing sepsis after major surgery was 0.87 (95% CI 0.81, 0.92).Conclusions:Plasma calprotectin is a diagnostic marker for sepsis after surgery, and its early diagnostic value is higher when combined with PCT.

高榕悦、韩玉珍、张晓珂、游潘、侯舒雅、袁懿昕、李文雄、黄立锋

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100020 北京,首都医科大学附属北京朝阳医院重症医学科

脓毒症 钙卫蛋白 诊断

2023

中华卫生应急电子杂志

中华卫生应急电子杂志

ISSN:
年,卷(期):2023.9(5)
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