ProADM、sRAGE、HMGB-1对ICU感染患者病情严重程度及预后的评估价值  

Evaluation value of ProADM,sRAGE and HMGB⁃1 for disease severity and prognosis of infection patients in ICU

作　　者：吴瑶[1] 时小妍 杨丽坤 周南[1] 高雅 周朝朝 赵丽[1] WU Yao;SHI Xiaoyan;YANG Likun;ZHOU Nan;GAO Ya;ZHOU Zhaozhao;ZHAO Li(Department of Emergency,the Second Affiliated Hospital of Xi􀆳an Jiaotong University,Xi’an,Shanxi,China,710004)

机构地区：[1]西安交通大学第二附属医院急诊科,陕西西安710004

出　　处：《分子诊断与治疗杂志》2020年第12期1700-1703,1707,共5页Journal of Molecular Diagnostics and Therapy

基　　金：陕西省重点研发计划项目(2018SF-018)。

摘　　要：目的探讨三种新型肾上腺髓质素前体(ProADM)、可溶性糖基化终末产物受体(sRAGE)、高迁移率族蛋白B-1(HMGB-1)炎症标志物水平对重症监护室(ICU)感染患者病情严重程度及预后的评估价值。方法选取2018年1月至2019年12月本院ICU收治的86例感染患者为研究对象,根据脓毒症定义的标准将其分为脓毒症组55例、脓毒性休克组31例;另选取40例同期本院健康体检者作为对照组。收集三组临床一般资料,于入院24 h内采用酶联免疫吸附法检测ProADM、sRAGE、HMGB-1水平。评估研究组患者急性生理学及慢性健康状况评分系统(APACHE Ⅱ)评分、序贯器官功能障碍评分(SOFA),并随访1个月,记录随访结果(死亡或存活)。采用Pearson相关性分析ProADM、sRAGE、HMGB-1与APACHE Ⅱ、SOFA评分及预后的相关性。结果三组的ProADM、sRAGE、HMGB-1指标比较差异具有统计学意义(P<0.05);经两两比较发现,脓毒症组及脓毒性休克组的ProADM、sRAGE、HMGB-1指标显著高于对照组,差异具有统计学意义(P<0.05);且脓毒性休克组的各指标显著高于脓毒症组,差异具有统计学意义(P<0.05)。脓毒性休克组的APACHE Ⅱ、SOFA评分均显著高于脓毒症组,差异具有统计学意义(P<0.05)。随访结果显示,有36例患者死亡,50例患者存活,死亡率为41.86%,死亡组患者的ProADM、sRAGE、HMGB-1指标显著高于存活组,差异具有统计学意义(P<0.05)。Pearson相关性分析结果显示,ProADM、sRAGE、HMGB-1指标与APACHE Ⅱ、SOFA评分及预后均呈正相关关系(P<0.05)。结论 ICU脓毒症患者ProADM、sRAGE、HMGB-1水平高于健康人,且与患者感染严重程度及预后情况密切相关。Objective To explore the evaluation value of levels of three inflammation markers[pro⁃adrenomedullin(ProADM),soluble receptor for advanced glycation endproducts(sRAGE),high mobility group box⁃1(HMGB⁃1)]for disease severity and prognosis of infection patients in intensive care unit(ICU).Methods A total of 86 infection patients who were admitted to ICU in the hospital from January 2018 to De⁃cember 2019 were enrolled as the study group.According to defined criteria of sepsis,they were divided into the sepsis group(55 cases)and the septic shock group(31 cases).Another 40 healthy people who underwent physical examination during the same period were enrolled as the control group.The general clinical data were collected.Within 24 h after admission,levels of ProADM,sRAGE and HMGB⁃1 were detected by enzyme⁃linked immunosorbent assay.The scores of acute physiology and chronic health evaluationⅡ(APACHEⅡ)and sequential organ failure assessment(SOFA)in study group were assessed.They were followed up for 1 month.And their follow⁃up results(death or survival)were recorded.The correlation between ProADM,sRAGE,HMGB⁃1 and APACHE II,SOFA scores,prognosis was analyzed by Pearson correlation analysis.Results The differences were statistically significant among the control group,the sepsis group and the septic shock group(P<0.05).After pairwise comparison,ProADM,sRAGE and HMGB⁃1 in the sepsis group and the septic shock group were significantly higher than those in the control group,and the differences were statistically sig⁃nificant(P<0.05).And the above indexes in the septic shock group were significantly higher than those in the sepsis group,and the differences were statistically significant(P<0.05).The scores of APACHE II and SOFA in the septic shock group were significantly higher than those in the sepsis group,and the differences were statis⁃tically significant(P<0.05).Follow⁃up results showed that there were 36 patients died and 50 patients survived,and the mortality was 41.86%.ProADM,sRAGE and HMGB�

关 键 词：肾上腺髓质素前体 可溶性糖基化终末产物受体 高迁移率族蛋白B-1 

分 类 号：R459.7[医药卫生—急诊医学]