脓毒症休克患者外周血HMGB1及PCT水平与疾病严重程度及预后的关系  

Relationship of peripheral blood HMGB1 and PCT levels with the severity and prognosis of septic shock

作　　者：郑晓晶[1] 胡周全 虎琼华[1] 崔巍[1] 张鸣[1] ZHENG Xiaojing;HU Zhouquan;HU Qionghua;CUI Wei;ZHANG Ming(ICU,Chengdu Second People's Hospital,Chengdu 610000,China;Emergency Department,Chengdu Second People's Hospital,Chengdu 610000,China)

机构地区：[1]成都市第二人民医院ICU,四川成都610000 [2]成都市第二人民医院急诊科,四川成都610000

出　　处：《西部医学》2022年第10期1517-1521,共5页Medical Journal of West China

基　　金：四川省医学会科研课题(Q1601897)。

摘　　要：目的探讨脓毒症休克患者外周血迁移率蛋白-1(HMGB1)、降钙素原(PCT)水平与疾病严重程度及预后的关系。方法选取2017年3月~2021年3月本院重症监护室收治的脓毒症休克患者72例为研究对象,采集患者外周血,采用酶联免疫吸附试验检测样本HMGB1、PCT水平,分析其与急性生理与慢性健康状况(APACHEⅡ)评分的关系。根据患者28 d存活情况,分为死亡组与生存组,对影响脓毒症休克患者预后的因素行回归分析。结果脓毒症休克患者外周血HMGB1水平与APACHEⅡ评分呈线性正相关(r=0.275,P=0.019);PCT与APACHEⅡ评分呈线性正相关(r=0.469,P<0.001);生存组HMGB1、PCT显著低于死亡组(P<0.05);Logistic回归分析结果显示,年龄、APACHEⅡ评分、Alb、HMGB1、PCT是脓毒症休克患者预后不良的危险因素(P<0.05)。Alb与HMGB1、PCT均呈负相关(r=-0.398、r=-0.274,P<0.05)。结论脓毒症休克患者外周血HMGB1、PCT水平不仅与疾病严重程度密切相关,也是脓毒症休克患者死亡的独立危险因素。Objective To detect the levels of peripheral blood high mobility group box 1(HMGB1)and procalcitonin(PCT)in patients with septic shock,and analyze their relationship with the severity and prognosis of the disease.Methods 72 patients with septic shock admitted to the intensive care unit of the hospital were selected as the research subjects from March 2017 to March 2021.Peripheral blood samples were collected form the patients to test the levels of HMGB1 and PCT by enzyme-linked immunosorbent assay.The relationship between the levels and the Acute Physiological and Chronic Health Evaluation Ⅱ(APACHEⅡ)score was analyzed.According to 28-day survival,the patients were divided into death group and survival group.Multivariate regression analysis was performed to screen the prognostic factors in patients with septic shock.Results The peripheral blood HMGB1 level was positively correlated with APACHEⅡ score in patients with septic shock(r=0.275,P=0.019),and PCT was positively correlated with APACHEⅡ score(r=0.469,P=0.000).HMGB1 and PCT in the survival group were significantly lower than those in the death group(P<0.05).Logistic regression analysis showed that HMGB1,PCT,age,APACHEⅡ score,and serum albumin were risk factors for poor prognosis of patients with septic shock(P<0.05).The plasma albumin level was negatively correlated with HMGB1 and PCT(r=-0.398,r=-0.274,P<0.05).Conclusion Peripheral blood HMGB1 and PCT levels in patients with septic shock are not only closely related to the severity of the disease,but also independent risk factors for death of such patients.

关 键 词：脓毒症 休克 迁移率蛋白-1 降钙素原 

分 类 号：R459.7[医药卫生—急诊医学]