sTRAIL、PCT、ALB在重症肝病合并感染患者外周血中的表达及临床意义  

Expression and clinical significance of serum sTRAIL,PCT,ALB in patients with severe liver disease and infection

作　　者：徐萍 伍廷平 夏红 时志鹏 杨强 刘荷蕾 XU Ping;WU Tingping;XIA Hong;SHI Zhipeng;YANG Qiang;LIU Helei(Department of infection,Dazu District People's Hospital,Chongqing,China,402360;Chongqing Dazu District People's Hospital,Chongqing,China,402360)

机构地区：[1]重庆市大足区人民医院感染科,重庆402360 [2]重庆市大足区人民医院老院区全科医疗,重庆402360

出　　处：《分子诊断与治疗杂志》2020年第6期746-750,共5页Journal of Molecular Diagnostics and Therapy

基　　金：重庆市卫生和计划生育委员会科研计划项目(2018ZBXM33781)。

摘　　要：目的探究可溶性肿瘤坏死因子相关凋亡诱导配体(sTRAIL)、降钙素原(PCT)、白蛋白(ALB)在重症肝病合并感染患者外周血中的表达及临床意义。方法选取本院2017年5月至2019年8月收治的重症肝病患者159例,根据是否合并感染分为合并感染患者55例(观察组),未合并感染患者104例(对照组)。检测两组不同治疗结局患者血清s TRAIL、PCT、ALB水平及肝功能指标[总胆红素(TBiL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)],分析血清sTRAIL、PCT、ALB与肝功能的关系,评价三者对治疗结局的预测价值。结果观察组血清sTRAIL、PCT水平高于对照组,ALB水平低于对照组(P<0.05);观察组血清TBiL、AST、ALT水平高于对照组(P<0.05);Pearson相关性分析,血清sTRAIL、PCT与TBiL、AST、ALT呈正相关,ALB与TBiL、AST、ALT呈负相关(P<0.05);治疗有效者治疗第7、14 d血清sTRAIL、PCT、ALB水平较治疗前显著降低,且均低于同期治疗无效者(P<0.05);ROC曲线分析,治疗第14 d血清TBiL、AST、ALT联合预测AUC为0.881,大于三者治疗第7、14 d单独预测价值。结论 s TRAIL、PCT、ALB在重症肝病合并感染患者外周血中异常表达,与肝功能密切相关,且联合检测有助于预测治疗结局。Objective To investigate the expression and clinical significance of serum soluble tumor necrosis factor-related apoptosis-inducing ligand(sTRAIL),procalcitonin(PCT),and albumin(ALB)in patients with severe liver disease and infection.Methods A total of 159 patients with severe liver disease admitted to our hospital from May 2017 to August 2019 were selected and divided into 55 patients with co-in-fection(observation group)and 104 patients without coinfection(control group)according to whether they were co-infected.The serum sTRAIL,PCT,ALB levels and liver function indexes[total bilirubin(TBiL),as-partate aminotransferase(AST),alanine aminotransferase(ALT)]were detected in two groups of patients with different treatment outcomes,and the relationship between serum sTRAIL,PCT,ALB and liver function was analyzed,and the predictive value of the three on the treatment outcome was evaluated.Results The serum levels of sTRAIL and PCT in the observation group were higher than those in the control group,and the levels of ALB were lower than those in the control group(P<0.05);serum TBiL,AST and ALT levels in the observation group were higher than those in the control group(P<0.05).Pearson correlation analysis showed that serum sTRAIL and PCT were positively correlated with TBiL,AST and ALT,and ALB was negatively correlated with TBiL,AST and ALT(P<0.05);the level of serum sTRAIL,PCT and ALB on the 7th and 14th day of treatment of those who were effective were significantly lower than those before treatment,and were lower than those who were ineffective during the same period(P<0.05);ROC curve analysis showed that the combined AUC predicted by serum TBiL,AST,and ALT on the 14th days of treatment was 0.881,which was greater than the individually predicted value on the 7th and 14th days of the three.Conclusion The abnormal expression of sTRAIL,PCT,and ALB in patients with severe liver disease and infection is closely related to the liver function,and combined detection can help predict the outcome of treatment.

关 键 词：重症肝病 感染 STRAIL PCT ALB 相关性 

分 类 号：R575[医药卫生—消化系统]