PTX-3在糖尿病酮症酸中毒继发感染患者中临床意义  

Clinical significance of PTX-3 in patients with secondary infection of diabetic ketoacidosis

作　　者：王春燕[1] 谷巍 侯丽萍[2] 耿建林[2] 张雪坤[2] WANG Chun-yan;GU Wei;HOU Li-ping(Department of Endocrinology,the Fourth People’s Hospital of Hengshui,Hengshui 053000,China;Department of Endocrinology,Harrison International Peace Hospital,Hengshui 053000,China)

机构地区：[1]衡水市第四人民医院内分泌科,河北衡水053000 [2]衡水市哈励逊国际和平医院内分泌科,河北衡水053000

出　　处：《中国实验诊断学》2022年第11期1597-1601,共5页Chinese Journal of Laboratory Diagnosis

基　　金：2019年河北省医学科学研究课题计划(20191770)。

摘　　要：目的研究正五聚蛋白-3(PTX-3)在糖尿病酮症酸中毒继发感染患者血清中的变化,分析PTX-3的临床意义。方法选取2020年1月-2022年1月衡水市第四人民医院收治的194例糖尿病酮症酸中毒患者为研究对象,入组后根据是否继发感染,分为研究组(n=88,继发感染者)和对照组(n=106,未继发感染者)。采用酶联免疫吸附法(ELISA)测定血清PTX-3水平,采用全自动生化分析仪测定血酮体、肌酐(Scr)、尿素氮、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白细胞计数(WBC)、中性粒细胞百分比、C反应蛋白。采用双抗夹心免疫发光法测定血清降钙素原(PCT)水平。采用受试者工作特征(ROC)曲线评价WBC、中性粒细胞百分比及血清PTX-3水平预测糖尿病酮症酸中毒继发感染的价值,多因素Logistic回归分析影响糖尿病酮症酸中毒继发感染的独立危险因素。结果研究组糖尿病病程[(4.93±1.56)年]及血酮体水平[(5.72±1.35)mmol/L]、WBC水平[(15.11±4.30)×10^(9)/L]、中性粒细胞百分比[(78.79±16.18)%]、血清中PCT[(0.82±0.26)ng/mL]、C反应蛋白[(17.27±4.35)mg/mL]及PTX-3水平[(106.52±27.21)ng/mL]高于对照组[(4.47±1.53)年、(3.32±0.82)mmol/L、(10.94±3.26)×10^(9)/L、(65.07±13.64)%、(0.55±0.17)ng/mL、(13.08±4.06)mg/mL、(56.38±18.37)ng/mL](P<0.05)。ROC曲线显示,血清中PTX-3水平预测糖尿病酮症酸中毒继发感染的AUC为0.885,其敏感度、特异性分别为83.30%、77.40%;WBC水平预测糖尿病酮症酸中毒继发感染的AUC为0.782,其敏感度、特异性分别为78.40%、66.00%;中性粒细胞百分比预测糖尿病酮症酸中毒继发感染的AUC为0.737,其敏感度、特异性分别为61.40%、77.40%;Logistic回归分析显示PTX-3是糖尿病酮症酸中毒继发感染的独立危险因素(P<0.05)。结论糖尿病酮症酸中毒继发感染患者血清中PTX-3水平呈高表达,可预测糖尿病酮症酸中毒继发感染。Objective To study the change of pentraxin-3(PTX-3)in serum of patients with secondary infection of diabetic ketoacidosis and analyze the clinical significance of PTX-3.Methods 194patients with diabetic ketoacidosis admitted to The Fourth People’s Hospital of Hengshui from January 2020to January 2022were the research subjects,after enrollment,according to whether there is secondary infection,they were divided into the study group(n=88,those with secondary infection)and the control group(n=106,those without secondary infection).The enzyme-linked immunosorbent assay(ELISA)was used to measure serum PTX-3level,the automatic biochemical analyzer was used to determine blood ketone body,creatinine(Scr),urea nitrogen,alanine aminotransferase(ALT),aspartate aminotransferase(AST),white blood cell count(WBC),percentage of neutrophils,C reactive protein.Determination of the level of procalcitonin(PCT)in serum by double-antibody sandwich immunoluminescence assay.Receiver operating characteristic(ROC)curve was used to evaluate the value of WBC,neutrophil percentage and serum PTX-3level in predicting the secondary infection of diabetic ketoacidosis,and multivariate logistic regression was used to analyze the independent risk factors affecting secondary infection of diabetic ketoacidosis.Results The study group had higher diabetes course[(4.93±1.56)year]and blood ketone body level[(5.72±1.35)mmol/L],WBC levell[(15.11±4.30)×10^(9)/L],percentage of neutrophilsl[(78.79±16.18)%],the levels of PCT[(0.82±0.26)ng/mL],C reactive protein[(17.27±4.35)mg/mL]and PTX-3[(106.52±27.21)ng/mL]in serum than those in the control group[(4.47±1.53)year,(3.32±0.82)mmol/L,(10.94±3.26)×10^(9)/L,(65.07±13.64)%,(0.55±0.17)ng/mL,(13.08±4.06)mg/mL,(56.38±18.37)ng/mL](P<0.05).The ROC curve shows that the AUC of serum PTX-3level predicting secondary infection of diabetic ketoacidosis was 0.885,and its sensitivity and specificity were 83.30%and 77.40%respectively;the AUC of WBC level predicting secondary infection of diabetic ketoacidosis wa

关 键 词：糖尿病酮症酸中毒 感染 正五聚蛋白-3 诊断价值 

分 类 号：R587.1[医药卫生—内分泌]