成纤维细胞生长因子21和降钙素原及高密度脂蛋白胆固醇联合检测对脓毒症的诊断价值  

The diagnostic value of combined detection of fibroblast growth factor-21,procalcitonin and high-density lipoprotein cholesterol in sepsis

作　　者：胡元慧 李欢[1] 汤冬玲[1] 张平安[1] Hu Yuanhui;Li Huan;Tang Dongling;Zhang Ping'an(Department of Clinical laboratory,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院检验科,武汉430060

出　　处：《中国医药》2022年第2期258-261,共4页China Medicine

基　　金：国家自然科学基金(81773444)。

摘　　要：目的探讨成纤维细胞生长因子21(FGF-21)、降钙素原及高密度脂蛋白胆固醇(HDL-C)联合检测对脓毒症的临床诊断价值。方法选取2020年9月至2021年8月武汉大学人民医院收治的脓毒症患者136例(脓毒症组)、同期普通感染患者82例(非脓毒症组)和同期常规健康体检者83例(对照组)作为研究对象。分别测定3组FGF-21、降钙素原与HDL-C水平。采用二元Logistic回归分析方法得到FGF-21、降钙素原与HDL-C联合的回归模型,并绘制FGF-21、降钙素原及HDL-C单独或联合检测的受试者工作特征(ROC)曲线,计算曲线下面积(AUC)及敏感度、特异度和约登指数。结果3组性别比例与年龄差异均无统计学意义(均P>0.05)。脓毒症组FGF-21与降钙素原水平明显高于非脓毒症组和对照组;非脓毒症组FGF-21与降钙素原水平明显高于对照组;脓毒症组HDL-C水平明显低于非脓毒症组和对照组,非脓毒症组HDL-C水平明显低于对照组,差异均有统计意义(均P<0.01)。ROC曲线分析结果显示FGF-21、降钙素原及HDL-C联合诊断的AUC为0.884,其95%置信区间为0.806~0.962,敏感度为87.2%,特异度为89.9%,AUC和约登指数大于各指标单独检测。结论FGF-21、降钙素原及HDL-C联合检测提高了脓毒症的诊断效能,具有较高的临床价值。Objective To investigate the clinical diagnostic value of combined detection of fibroblast growth factor-21(FGF-21),procalcitonin and high-density lipoprotein cholesterol(HDL-C)in sepsis.Methods From September 2020 to August 2021,136 patients with sepsis(sepsis group),82 patients with common infection(non-sepsis group)and 83 patients undergoing routine physical examination(control group)in Renmin Hospital of Wuhan University were selected.The levels of FGF-21,procalcitonin and HDL-C were measured in the three groups.Binary Logistic regression analysis was used to obtain the regression model of FGF-21,procalcitonin and HDL-C combined.The receiver operating characteristic(ROC)curve of FGF-21,procalcitonin and HDL-C alone or in combination was drawn to calculate the area under the curve(AUC),sensitivity,specificity and Youden index.Results There were no significant differences in gender and age among the three groups(both P>0.05).The levels of FGF-21 and procalcitonin in the sepsis group were significantly higher than those in the non-sepsis group and control group,and those in the non-sepsis group were significantly higher than those in the control group;the level of HDL-C in the sepsis group was significantly lower than that in the non-sepsis group and control group,and that in the non-sepsis group was significantly lower than that in the control group(all P<0.01).ROC curve analysis showed that the AUC of the combined diagnosis of FGF-21,procalcitonin and HDL-C was 0.884,95%confidence interval:0.806-0.962,the sensitivity was 87.2%,and the specificity was 89.9%.The AUC and Youden index of those combined diagnosis were greater than those detected separately.Conclusion The combined detection of FGF-21,procalcitonin and HDL-C improves the diagnostic efficiency of sepsis and has high clinical value.

关 键 词：脓毒症 成纤维细胞生长因子21 高密度脂蛋白胆固醇 降钙素原 

分 类 号：K631.2[历史地理—历史学]