血清SAA、HBP、IL-8水平与脓毒症患者病情严重程度及28天预后的关系  

Relationship between serum SAA,HBP,IL-8 levels and the severity of sepsis and 28-day prognosis in patients with sepsis

作　　者：赵静媛 张玉红 吴雪 董龙[3] 李素清[1] ZHAO Jing-yuan;ZHANG Yu-hong;WU Xue;DONG Long;LI Su-qing(Department of Intensive Care,Affiliated Hospital of Chengde Medical University,Chengde 067000,Hebei,China;Department of Blood Laboratory,Affiliated Hospital of Chengde Medical University,Chengde 067000,Hebei,China;Department of Anesthesiology,Affiliated Hospital of Chengde Medical University,Chengde 067000,Hebei,China)

机构地区：[1]承德医学院附属医院重症医学科,河北承德067000 [2]承德医学院附属医院血液检验室,河北承德067000 [3]承德医学院附属医院麻醉科,河北承德067000

出　　处：《川北医学院学报》2024年第6期811-814,共4页Journal of North Sichuan Medical College

基　　金：河北省承德市科学技术研究与发展计划项目(202109A047)。

摘　　要：目的:探讨血清淀粉样蛋白A(SAA)、肝素结合蛋白(HBP)、白细胞介素8(IL-8)水平与脓毒症患者病情严重程度及28 d预后的相关性。方法:将106例脓毒症患者按照病情严重程度分为非休克组(n=82)及休克组(n=24);按照28 d预后情况将患者分死亡组(n=32)与存活组(n=74)。比较不同病情严重程度患者血清SAA、HBP、IL-8水平的差异,采用Logistic回归分析与脓毒症患者28 d预后相关的风险因素;绘制受试者工作特征(ROC)曲线验证各指标的诊断效能。结果:休克组患者血清SAA、HBP及IL-8水平均高于非休克组(P<0.05)。死亡组患者APACHEⅡ评分、NEWS评分、SOFA评分、WBC、CRP、PCT、SAA、HBP及IL-8水平均高于存活组(P<0.05)。Logistic回归分析结果显示,高APACHEⅡ评分、高SAA、HBP及IL-8水平是脓毒症患者28 d死亡的风险因素(P<0.05)。ROC曲线结果显示,SAA、HBP及IL-8预测脓毒症患者28 d死亡的曲线下面积(AUC)分别为0.871、0.828、0.769,APACHEⅡ评分预测的AUC为0.801;各项指标联合诊断的AUC为0.982,敏感度和特异度分别为93.75%和97.30%。结论:血清SAA、HBP、IL-8水平均能较好评估脓毒症患者病情严重程度及28 d预后,且联合APACHEⅡ评分诊断时效能更高。Objective:To investigate the relationship between serum levels of amyloid A(SAA),heparin-binding protein(HBP),interleukin-8(IL-8)and the severity and 28-day prognosis of patients with sepsis.Methods:106 patients with sepsis were divided into non-shock group(n=82)and shock group(n=24)according to the severity of the disease.According to the 28-day prognosis,the patients were divided into death group(n=32)and survival group(n=74).The differences of serum SAA,HBP and IL-8 levels in patients with different severity of disease were compared.Univariate and multivariate Logistic regression analysis were used to establish independent risk factors affecting the 28-day prognosis of patients with sepsis.By using receiver operating characteristic(ROC)curve to verify the diagnostic efficacy of SAA,HBP and IL-8 on the 28-day prognosis of patients with sepsis.Results:Compared with the non-shock group,the levels of serum SAA,HBP and IL-8 in the shock group were higher(P<0.05).Compared with the survival group,APACHE II score,NEWS score,SOFA score,WBC,CRP,PCT,SAA,HBP and IL-8 were higher in the death group(P<0.05).Logistic regression analysis showed that higher APACHE II score and higher levels of SAA,HBP and IL-8 were independent risk factors for 28-day mortality in patients with sepsis(P<0.05).The results of ROC curve showed that the AUC s of SAA,HBP and IL-8 in predicting 28-day mortality of sepsis patients were 0.871,0.828 and 0.769,respectively,and the AUC predicted by APACHE II score was 0.803.The AUC of combined diagnosis of each index was 0.982,the sensitivity and specificity were 93.75%and 97.30%,respectively.Conclusion:Serum SAA,HBP and IL-8 levels can better evaluate the severity and 28-day prognosis of patients with sepsis,and the diagnostic efficacy is higher when combined with APACHE II score.

关 键 词：脓毒症 淀粉样蛋白A 肝素结合蛋白 白细胞介素-8 病情严重程度 预后 

分 类 号：R363[医药卫生—病理学]