肝素结合蛋白对脓毒症相关急性呼吸窘迫综合征的预测价值研究  

Prediction value of heparin binding protein for acute respiratory distress syndrome associated with sepsis

作　　者：张团结 韩来新[1] 王伟[2] 刘兵 

机构地区：[1]东营市胜利医院检验科,257055 [2]东营市胜利医院血液肿瘤科,257055

出　　处：《传染病信息》2018年第1期41-42,47,共3页Infectious Disease Information

摘　　要：目的探讨肝素结合蛋白(heparin binding protein,HBP)对脓毒症相关急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的预测价值。方法选择2016年6月—2017年6月在我院ICU诊疗并发生ARDS的30例脓毒症患者为ARDS组,30例未发生ARDS的脓毒症患者为非ARDS组。另选取30例健康志愿者为对照组。观察各组HBP、超敏C反应蛋白(hypersensitive C reactive protein,hs-CRP)、IL-6水平的差异,测算脓毒症患者入院48 h内HBP、hs-CRP、IL-6水平对发生ARDS的预测价值。结果 HBP、hs-CRP及IL-6在3组之间差异具有统计学意义(P均<0.05);ARDS组和非ARDS组均明显高于对照组(P均<0.05),且ARDS组均明显高于非ARDS组(P均<0.05)。入院48 h,患者HBP对脓毒症相关ARDS预测价值最高,其最佳界值为28.56 ng/ml,ROC曲线下面积为0.834,诊断敏感度及特异度分别为86.2%和79.3%,约登指数为0.655。结论在脓毒症相关ARDS的预测中,HBP具有较高的价值。Objective Investigate the prediction value of heparin binding protein（HBP） for acute respiratory distress syndrome（ARDS） associated with sepsis. Methods Sixty sepsis patients treated at ICU in our hospital from June 2016 to June 2017 were included in this study, 30 cases developing ARDS served as ARDS group and 30 cases without ARDS as non-ARDS group. Another 30 healthy volunteers were taken as control group. HBP, hypersensitive C reactive protein（hs-CRP） and IL-6 levels were measured and compared among 3 groups. The significance of HBP, hs-CRP and IL-6 levels on the prediction of ARDS in sepsis patients within 48 hours after admission was detected. Results The difference of HBP, hs-CRP and IL-6 levels among 3 groups had statistically significant（P〈0.05）. The measured levels of HBP, hs-CRP and IL-6 in ARDS group and non-ARDS group were significantly higher than those in control group（P〈0.05）, and ARDS group showed significantly higher levels than non-ARDS group（P〈0.05）. HBP had the highest prediction value for sepsis related ARDS within 48 hours after admission. The best cut-off value was 28.56 ng/ml, the area under curve was 0.834, the sensitivity and specificity of diagnosis were 86.2% and 79.3%, the Youden index was 0.655. Conclusions HBP has a relative high value in the prediction of sepsis related ARDS.

关 键 词：肝素结合蛋白 脓毒症 急性呼吸窘迫综合征 感染 

分 类 号：R563.8[医药卫生—呼吸系统] R446.113[医药卫生—内科学]