脓毒症患者血清VitD、FRT、HB-EGF表达情况与预后预测价值探讨  

Expression and prognostic value of serum VitD, FRT and HB-EGF in sepsis patients

作　　者：唐宁 汤展宏[2] 易其琼 TANG Ning;TANG Zhan-hong;YI Qi-qiong(Department of Critical Care Medicine,Traditional Chinese Medicine Hospital of Wuming District of Guangxi Zhuang Autonomous Region,Nanning 530199,China;Department of Critical Care Medicine,The First Affilia-ted Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西壮族自治区南宁市武鸣区中医医院重症医学科,广西南宁530199 [2]广西医科大学第一附属医院重症医学科,广西南宁530021

出　　处：《中国感染控制杂志》2024年第2期142-147,共6页Chinese Journal of Infection Control

基　　金：国家自然科学基金项目(81960342);国家临床重点专科建设项目(20115245)。

摘　　要：目的 探讨分析脓毒症患者血清维生素D(VitD)、铁蛋白(FRT)、肝素结合性表皮生长因子(HB-EGF)表达情况与预后预测价值。方法 选取2021年1月—2022年1月某院重症监护病房收治的86例脓毒症患者作为病例组,并选择重症监护病房中60例非脓毒症患者作为对照组。根据脓毒症患者1个月后预后情况,将患者分为存活组和死亡组。入院时采集患者血清,检测血清VitD、FRT、HB-EGF水平,分析其表达水平与脓毒症患者预后的相关性,并采用受试者工作特征曲线下面积(AUC)评估其对预后的预测价值。结果 病例组脓毒症患者白细胞计数、C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子(TNF-α)、白细胞介素(IL)-6、IL-1β、FRT水平高于对照组非脓毒症患者,VitD、HB-EGF水平低于对照组非脓毒症患者,差异均有统计学意义(均P<0.05)。随访脓毒症患者1个月后预后情况,55例存活,31例死亡。死亡组患者APACHEⅡ评分、SOFA评分、PCT、TNF-α、IL-1β、FRT高于存活组患者,而VitD、HB-EGF低于存活组患者,差异均有统计学意义(均P<0.05)。Pearson相关性分析结果显示,VitD与APACHEⅡ评分、SOFA评分、白细胞计数、CRP、PCT、TNF-α呈负相关关系(均P<0.05);HB-EGF与APACHEⅡ评分、CRP、PCT、TNF-α、IL-6、IL-1β呈负相关关系(均P<0.05);FRT与APACHEⅡ评分、CRP、PCT、TNF-α、IL-6、IL-1β呈正相关关系(均P<0.05)。血清VitD、FRT、HB-EGF联合检测预测脓毒症患者预后的AUC为0.82(95%CI:0.72~0.86),灵敏度为84.39%,特异度为69.35%。结论 脓毒症患者血清VitD、HB-EGF水平较低,FRT水平较高,其表达水平与患者预后密切相关,对预测脓毒症患者预后具有较好预测价值。Objective To explore and analyze the expression and prognostic value of serum vitamin D(VitD),ferritin(FRT)and heparin-binding epidermal growth factor(HB-EGF)in sepsis patients.Methods 86 sepsis patients who were admitted to the intensive care unit(ICU)of a hospital from January 2021 to January 2022 were selected as the case group,and 60 non-sepsis patients in the ICU were selected as the control group.According to the prognosis of sepsis patients one month later,patients were divided into survival group and death group.Patient’s serum upon admission was taken,levels of serum VitD,FRT and HB-EGF were detected,the correlation with the prognosis of sepsis patients was analyzed,and the prognostic value was evaluated by area under curve(AUC)of receiver opera-ting characteristic curve.Results Levels of white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1βand FRT of case group were all higher than those of non-sepsis patients in the control group,while the VitD and HB-EGF levels were lower than those of non-sepsis patients in the control group,differences were all statistically significant(all P<0.05).One month follow-up on the prognosis of sepsis patients showed that 55 patients survived and 31 died.Acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,sequential organ failure assessment(SOFA)score,PCT,TNF-α,IL-1βand FRT score in patients in the death group were all higher than those in patients in the survival group,while VitD and HB-EGF were lower than patients in the survival group,differences were all statistically significant(all P<0.05).The Pearson correlation analysis results showed that VitD were negatively correlated with APACHEⅡscore,SOFA score,WBC,CRP,PCT and TNF-α(all P<0.05),HB-EGF was negatively correlected with APACHEⅡ,score,CRP,PCT,TNF-α,IL-6 and IL-1β(all P<0.05);while FRT was positively correlated with APACHEⅡscores,CRP,PCT,TNF-α,IL-6 and IL-1β(all P<0.05).The AUC,sensitivity,and specificity of combi

关 键 词：脓毒症 维生素D 铁蛋白 肝素结合性表皮生长因子 预后 ROC曲线 

分 类 号：R181.32[医药卫生—流行病学]