血清载脂蛋白A5、可溶性Fas受体配体、脑钠肽预测脓毒症患儿短期预后的价值  

The value of serum apolipoprotein A5,soluble Fas receptor ligand and brain natriuretic peptide in predicting short-term prognosis of children with sepsis

作　　者：邢静[1] 王艳飞[1] 闫慧娟[1] 王新梅 刘振奎[1] XING Jing;WANG Yanfei;YAN Huijuan;WANG Xinmei;LIU Zhenkui(Department of Pediatric Internal Medicine,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院儿内科,河北张家口075000

出　　处：《国际检验医学杂志》2022年第23期2896-2901,共6页International Journal of Laboratory Medicine

基　　金：河北省2020年度医学科学研究课题计划(20200503)。

摘　　要：目的探讨血清载脂蛋白A5(ApoA5)、可溶性Fas受体配体(sFasL)、脑钠肽(BNP)对脓毒症患儿短期预后的预测价值。方法选取该院2018年5月至2021年5月收治的脓毒症患儿116例作为脓毒症组,另选取同期体检的健康儿童87例作为对照组。比较两组血清ApoA5、sFasL、BNP水平,根据脓毒症患儿在儿童重症监护室(PICU)住院期间的预后情况又将其分成存活组与死亡组,分析患儿短期预后的影响因素。绘制受试者工作特征(ROC)曲线分析血清ApoA5、sFasL、BNP单独及联合检测对脓毒症患儿短期预后的预测价值。结果脓毒症组血清ApoA5水平低于对照组,sFasL、BNP水平高于对照组,差异有统计学意义(P<0.05)。116例脓毒症患儿住院期间存活81例(69.83%),死亡35例(30.17%)。多因素Logistic回归分析结果显示,器官功能障碍数量≥2种、有脓毒症休克、白细胞计数≥15.07×109/L、降钙素原≥22.62 ng/L、快速脓毒症相关器官功能障碍评定(qSOFA)评分≥5.01分、sFasL≥50.73 pg/mL、BNP≥459.57 pg/mL是脓毒症患儿短期预后的独立危险因素(P<0.05),而小儿危重病例评分表(PCIS)评分≥74.63分、ApoA5≥201.79 ng/L是脓毒症患儿短期预后的独立保护因素(P<0.05)。血清ApoA5、sFasL、BNP单独检测预测脓毒症患儿短期预后的曲线下面积(AUC)分别为0.756、0.832、0.821,3项指标联合检测的AUC为0.871。结论脓毒症患儿血清sFasL、BNP水平升高,ApoA5水平下降,其对患儿的短期预后具有一定影响,且3项指标联合还可辅助用于脓毒症患儿短期预后的预测。Objective To explore the predictive value of serum apolipoprotein A5(ApoA5),soluble Fas receptor ligand(sFasL)and brain natriuretic peptide(BNP)in the short-term prognosis of children with sepsis.Methods A total of 116 children with sepsis admitted to the hospital from May 2018 to May 2021 were selected as the sepsis group,and 87 healthy children who underwent physical examination during the same period were selected as the control group.The serum levels of ApoA5,sFasL and BNP were compared between the two groups.Children with sepsis were divided into survival group and death group according to their prognosis during hospitalization in pediatric intensive care unit(PICU).The influencing factors of short-term prognosis in children with sepsis were analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of ApoA5,sFasL and BNP alone and in combination for the short-term prognosis of children with sepsis.Results The level of serum ApoA5 in sepsis group was lower than that in control group,and the levels of sFasL and BNP were higher than those in control group,and the differences were statistically significant(P<0.05).Among 116 children with sepsis,81(69.83%)survived and 35(30.17%)died during hospitalization.Multivariate Logistic regression analysis showed that number of organ dysfunction≥2,septic shock,WBC≥15.07×109/L,PCT≥22.62 ng/L,quick Sepsis Related Organ Failure Assessment(qSOFA)score≥5.01,sFasL≥50.73 pg/mL,BNP≥459.57 pg/mL were independent risk factor for short-term prognosis in children with sepsis(P<0.05),pediatric critical illness scoring(PCIS)score≥74.63 and ApoA5≥201.79 ng/L were independent protective factors for short-term prognosis in children with sepsis(P<0.05).The area under the curve(AUC)of ApoA5,sFasL and BNP alone in predicting the short-term prognosis of children with sepsis were 0.756,0.832 and 0.821,respectively,and the AUC of the combined detection of the three indicators was 0.871.Conclusion The serum sFasL and BNP levels are increas

关 键 词：脓毒症 儿童 载脂蛋白A5 可溶性Fas受体配体 脑钠肽 短期预后 

分 类 号：R720.597[医药卫生—急诊医学]