肝素结合蛋白联合炎性细胞因子在重症肺炎合并脓毒症患者预后评估中的价值  

The Value of Heparin Binding Protein Combined with Inflammatory Cytokines in the Prognosis Evaluation of Patients withSevere Pneumonia and Sepsis

作　　者：邵丽娇 王鑫[1] 闫丽静[1] 牛艳慧[1] 于娣[1] 李宁[1] SHAO Lijiao;WANG Xin;YAN Lijing;NIU Yanhui;YU Di;LI Ning(Department of Intensive Care Medicine,Hebei Chest Hospital,Shijiazhuang 050000,China)

机构地区：[1]河北省胸科医院重症医学科,河北石家庄050000

出　　处：《标记免疫分析与临床》2024年第5期813-817,854,共6页Labeled Immunoassays and Clinical Medicine

基　　金：河北省卫生厅科研基金项目(编号:20231217)。

摘　　要：目的探究肝素结合蛋白(HBP)联合炎性细胞因子在重症肺炎合并脓毒症患者预后评估中的价值。方法选取在我院2021年6月至2022年12月收治的126例重症肺炎合并脓毒症患者即为研究组,同期选择在我院收治的肺炎患者126例为肺炎组和在我院体检健康的人群126例为对照组。对所有研究组患者入院后进行为期28d预后状况跟踪,根据死亡情况分为死亡组45例、生存组81例。采用全自动免疫分析检测血清中HBP水平;采用酶联免疫吸附试验(ELISA)检测血清中白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)水平。采用Pearson法分析血清中HBP与IL-6、IL-8、IL-10水平的相关性;受试者工作特征(ROC)曲线分析血清HBP、IL-6、IL-8、IL-10对重症肺炎合并脓毒症患者预后的评估价值。结果与对照组相比,研究组和肺炎组血清中HBP、IL-6、IL-8水平显著升高,与肺炎组相比,研究组HBP、IL-6、IL-8水平显著升高;与对照组相比,研究组和肺炎组血清中IL-10水平显著降低,与肺炎组相比,研究组IL-10水平显著降低(P<0.05)。相关性分析显示,重症肺炎合并脓毒症患者血清中HBP水平与IL-6、IL-8水平呈正相关关系,与IL-10呈负相关关系(P<0.05)。死亡组血清中HBP、IL-6、IL-8的水平与生存组相比显著升高,IL-10水平显著降低(P<0.05)。血清HBP、IL-6、IL-8、IL-10联合预测重症肺炎合并脓毒症患者预后的AUC高于各指标单独预测的AUC值(Z=8.728,P=0.003;Z=10.046,P<0.001;Z=10.694,P<0.001;Z=6.402,P=0.006)。结论重症肺炎合并脓毒症患者血清中HBP水平和炎性细胞因子IL-6、IL-8明显升高,IL-10明显降低,HBP联合炎性细胞因子对重症肺炎合并脓毒症患者预后有较高的预测价值。Objective To explore the value of heparin binding protein(HBP)combined with inflammatory cytokines in the prognosis evaluation of patients with severe pneumonia and sepsis.Methods A total of 126 patients with severe pneumonia combined with sepsis admitted to our hospital from June,2021 to December,2022 were selected as the study group,while 126 patients with pneumonia admitted to our hospital during the same period were selected as the pneumonia group and 126 healthy people in our hospital as the control group.All patients in the study group were followed up for 28 days after admission,and were then divided into the death group(45 cases)and the survival group(81 cases).The serum HBP level was detected by automatic immunoassay.Enzyme linked immunosorbent assay(ELISA)was applied to detect expression levels of interleukin-6(IL-6),interleukin-8(IL-8),and interleukin-10(IL-10)in serum.Pearson method was applied to evaluate the correlation between HBP and IL-6,IL-8,and IL-10 expression levels;Receiver operating characteristic(ROC)curve was drawn to assess the prognostic value of serum HBP,IL-6,IL-8,and IL-10 in patients with severe pneumonia and sepsis.Results Compared with the control group,expression levels of HBP,IL-6 and IL-8 in serum in the study group and the pneumonia group were significantly increased,and levels of HBP,IL-6 and IL-8 in the study group were significantly increased compared with the pneumonia group.Compared with the control group,the serum IL-10 level in the study group and the pneumonia group was significantly decreased,while the serum IL-10 level in the study group was significantly decreased compared with the pneumonia group(P<0.05).Correlation analysis showed that the expression level of HBP in the serum of patients with severe pneumonia and sepsis was positively correlated with levels of IL-6 and IL-8,while negatively correlated with IL-10(P<0.05).Expression levels of HBP,IL-6,and IL-8 in the serum of the death group were significantly increased compared to the survival group,while the IL-10

关 键 词：肝素结合蛋白 炎性细胞因子 重症肺炎 脓毒症 预后 

分 类 号：R563.1[医药卫生—呼吸系统]