肠道菌群、血清ET、PCT水平与脓毒症病情程度、预后的相关性  

Correlation between Gut Microbiota,Serum ET,PCT Levels with the Severity and Prognosis of Sepsis

作　　者：牛俊杰 姬文娟 于拽拽 NIU Junjie;JI Wenjuan;YU Zhuaizhuai(Dept.of Clinical Laboratory,Jincheng General Hospital,Jincheng Shanxi 048006,China)

机构地区：[1]晋城大医院检验科,山西晋城048006

出　　处：《昆明医科大学学报》2024年第4期140-145,共6页Journal of Kunming Medical University

基　　金：山西省应用基础研究计划基金资助项目(201901D111342)。

摘　　要：目的探讨脓毒症患者肠道菌群、血清内毒素(ET)、降钙素原(PCT)水平与病情程度、预后的相关性。方法选取2016年1月至2022年12月晋城大医院373例脓毒症患者,根据脓毒症病情程度分为脓毒症组(n=261)、脓毒症休克组(n=112)。比较2组一般资料、肠道菌群、血清ET、PCT水平,并比较不同肠道菌群紊乱程度患者血清ET和PCT水平,分析血清PCT、ET水平与脓毒症肠道菌群紊乱程度的关系。统计患者28 d预后,比较死亡与存活患者入院时肠道菌群、血清ET、PCT水平,分析肠道菌群、血清ET、PCT水平预测预后的价值。结果脓毒症休克组双歧杆菌、乳酸杆菌计数低于脓毒症组,大肠埃希菌、肠球菌属计数及血清ET、PCT水平高于脓毒症组(P<0.05);肠道菌群紊乱程度Ⅲ度患者血清ET、PCT水平高于Ⅱ度、Ⅰ度患者,Ⅱ度患者高于Ⅰ度患者(P<0.05);脓毒症患者血清ET、PCT水平与肠道菌群紊乱程度呈正相关(P<0.05);死亡患者入院时双歧杆菌、乳酸杆菌计数低于存活患者,肠球菌属、大肠埃希菌计数及血清ET、PCT水平高于存活患者(P<0.05);双歧杆菌、肠球菌属、大肠埃希菌、乳酸杆菌、血清ET、PCT预测预后为死亡的曲线下面积(AUC)分别为0.788、0.782、0.787、0.768、0.791、0.776,联合预测的AUC最大,为0.928(P<0.05)。结论脓毒症患者肠道菌群、血清ET、PCT水平与病情程度密切相关,且在预测预后方面具有较好应用价值。Objective To investigate the correlation between the levels of intestinal flora,serum endotoxin(ET),and procalcitonin(PCT)in patients with sepsis and their disease severity and prognosis.Methods A total of 373 patients with sepsis in Jincheng University Hospital from January 2016 to December 2022 were selected and divided into sepsis group(n=261)and sepsis shock group(n=112)according to the severity of sepsis.The general data,intestinal flora,serum ET and PCT levels were compared between the two groups,and the serum ET and PCT levels were compared among patients with different degrees of intestinal flora disturbance.The relationship between serum PCT and ET levels and the degree of intestinal flora disturbance in sepsis was analyzed.The prognosis of patients for 28 days was statistically analyzed,and the intestinal flora,serum ET,and PCT levels at the time of admission were compared between dead and alive patients to analyze the value of intestinal flora,serum ET,and PCT levels in predicting prognosis.Results Patients in the septic shock group had lower counts of bifidobacteria and lactobacilli compared to the sepsis group,while counts of Escherichia coli,enterococci,as well as serum levels of ET and PCT were higher in the septic shock group.The severity of disruption in gut microbiota was associated with higher serum levels of ET and PCT,with level Ⅲ patients having higher levels than level Ⅱ and level Ⅰ patients.The levels of ET and PCT in septic patients were positively correlated with the severity of disruption in gut microbiota.Upon admission,deceased patients had lower counts of bifidobacteria and lactobacilli compared to surviving patients,while counts of enterococci,Escherichia coli,as well as serum levels of ET and PCT were higher in deceased patients.The predictive value for prognosis of death for bifidobacteria,enterococci,Escherichia coli,lactobacilli,ET,and PCT were 0.788,0.782,0.787,0.768,0.791,and 0.776 respectively.The combined predictive value had the highest AUC of 0.928.Conclusion The int

关 键 词：脓毒症 肠道菌群 内毒素 降钙素原 预后 

分 类 号：R459.7[医药卫生—急诊医学]