炎性因子标志物评估脓毒症慢重症进展风险的价值研究  

Value of inflammatory factor markers in assessing the risk of chronic critical progress in sepsis

作　　者：叶俊男[1] 毛俊威 欧阳福康 吴德军[1] YE Jun-nan;MAO Jun-wei;OUYANG Fu-kang;WU De-jun(Quzhou People's Hospital,Zhejiang 324000,China)

机构地区：[1]衢州市人民医院,浙江324000

出　　处：《中国卫生检验杂志》2023年第7期823-826,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医学会临床科研基金项目(2021ZYC-A213)。

摘　　要：目的探讨炎性因子标志物评估脓毒症慢重症(CCI)进展风险的价值。方法回顾性分析2019年5月—2022年6月本院ICU收治的119例脓毒症患者的临床资料,根据临床转归将患者分为CCI组52例和非CCI组67例,比较2组患者临床资料和炎性因子标志物水平变化,采用logistic回归分析影响脓毒症进展为CCI的风险因素,采用受试者工作特征曲线分析炎性因子标志物评估脓毒症CCI风险的价值。结果CCI组患者年龄、感染性休克比例、AGI分级、APACHEⅡ评分、SOFA评分、PCT、IL-6、NEU、NLR高于非CCI组(P<0.05),LYM低于非CCI组(P<0.05);年龄、AGI分级、APACHEⅡ评分、SOFA评分、PCT、NEU、LYM、NLR是脓毒症进展为CCI的独立风险因素(P<0.05);PCT、NEU、LYM、NLR预测脓毒症CCI进展风险的AUC分别为0.721、0.697、0.681、0.804,NLR预测价值最高;随着ICU住院时间的延长,脓毒症患者PCT、NEU、NLR逐渐降低,LYM逐渐升高,且CCI组患者各时间段PCT、NEU、NLR低于非CCI组(P<0.05),LYM水平高于非CCI组(P<0.05)。结论PCT、NEU、LYM和NLR与脓毒症CCI的发生关系密切,在预测CCI风险方面有一定价值。Objective This paper aims to explore the value of inflammatory markers in assessing the risk of chronic critical progress in sepsis.Methods Clinical data of 119 patients with sepsis treated in ICU from May 2019 to June 2022 were retrospectively analyzed.Patients were divided into CCI group(n=52)and non-CCI group(n=67)according to clinical outcomes;clinical data and changes in inflammatory factor markers were compared between the two groups.Logistic regression was used to analyze the risk factors affecting the progression of sepsis to CCI,and the value of inflammatory markers in evaluating the risk of sepsis for CCI was analyzed using subject operating characteristic curves.Logistic regression was used to analyze the influencing factors of CCI,and subject operating characteristic curve was used to analyze the value of inflammatory markers in assessing the CCI risk.Results Age,proportion of septic shock,AGI rating,APACHEⅡscore,SOFA score,PCT,IL-6,NEU and NLR in CCI group were higher than those in non-CCI group(P<0.05).LYM was lower than that in non-CCI group(P<0.05).Age,AGI grading,APACHEⅡscore,SOFA score,PCT,NEU,LYM,and NLR were independent risk factors for CCI(P<0.05).The AUC of PCT,NEU,LYM and NLR in predicting the risk of CCI were 0.721,0.697,0.681 and 0.804,and NLR had the highest predictive value.With the length of stay in ICU,the PCT,NEU and NLR of sepsis patients gradually decreased,while LYM gradually increased,and PCT,NEU and NLR in CCI group were lower than those in non-CCI group(P<0.05),and LYM level was higher than that of non-CCI group(P<0.05).Conclusion PCT,NEU,LYM and NLR are closely related to the CCI of sepsis,and have certain value in predicting the risk of CCI.

关 键 词：脓毒症 慢重症 降钙素原 中性粒细胞 淋巴细胞 

分 类 号：R631[医药卫生—外科学]