肝素结合蛋白联合白细胞介素6对脓毒血症的诊断和病情评估价值  

Diagnostic and disease assessment value of heparin-binding protein combined with interleukin-6 in sepsis

作　　者：张白银[1] 伍银银 陈正徐[1] ZHANG Bai-yin;WU Yin-yin;CHEN Zheng-xu(Department of Clinical Laboratory,The Second People's Hospital of Hefei,Hefei 23001l,China;The Second People's Hospital of Hefei,Department of Critical Care Medicine,The Second People's Hospital of Hefei,Hefei 23001l,China)

机构地区：[1]合肥市第二人民医院检验科,安徽合肥230011 [2]合肥市第二人民医院重症医学科,安徽合肥230011

出　　处：《哈尔滨医科大学学报》2024年第3期284-288,共5页Journal of Harbin Medical University

基　　金：安徽省高校自然科学研究重点项目(2022AH051437)。

摘　　要：目的评估肝素结合蛋白联合白细胞介素6在脓毒血症诊断中的应用价值。方法回顾性分析2020年6月~2023年6月本院108例脓毒血症患者的临床资料,根据病情分为重症组(n=41)和轻症组(n=67),另外选取同期因感染入院的非脓毒血症患者60例作为对照组,收集3组患者的基本资料,比较3组患者的系统免疫炎症指数(systemic immune inflammation index,SII)、急性生理与慢性健康状况Ⅱ(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)评分和序贯器官衰竭(sequential organ failure assessment,SOFA)评分,并测定淀粉样蛋白A(serum amyloid A,SAA)、中性粒细胞CD64、白细胞介素6(interleukin-6,IL-6)和肝素结合蛋白(heparin binding protein,HBP)水平。通过Logistic多因素分析探讨SII、APACHEⅡ、SOFA、SAA、CD64、IL-6和HBP与脓毒血症患者病情程度的关系,利用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析IL-6和HBP对脓毒血症患者的诊断价值。结果对照组患者的SII、APACHEⅡ、SOFA、SAA、CD64、IL-6和HBP均低于重症组和轻症组,Logistic回归分析显示,脓毒血症患者的SII、APACHEⅡ、SOFA、SAA、CD64、IL-6和HBP均是影响病情程度的重要因素(均P<0.05),且IL-6和HBP联合对脓毒血症患者的诊断的ROC下曲线面积为0.948。结论IL-6和HBP联合检测对脓毒血症患者的诊断和病情评估有较高的诊断价值。Objective To evaluate the application value of heparin-binding protein combined with interleukin-6 in the diagnosis of sepsis.Methods Clinical data of 108 patients with sepsis admitted to our hospital from June 2020 to June 2023 were retrospectively analyzed.They were divided into a severe sepsis group(n=41)and a general sepsis group(n=67).Additionally,60 non-sepsis patients admitted due to infection were selected as the control group.Clinical data of all three groups were collected.The systemic immune inflammation index(SII),Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,sequential organ failure assessment(SOFA)score,as well as levels of serum amyloid A(SAA),neutrophil CD64,interleukin-6(IL-6),and heparin-binding protein(HBP)were compared.Logistic multivariate analysis was used to explore the relationship between SII,APACHEⅡ,SOFA,SAA,CD64,IL-6,and HBP levels and the severity of sepsis in patients.The diagnostic value of IL-6 and HBP in sepsis patients was analyzed using the receiver operating characteristic(ROC)curve.Results The SII,APACHEⅡ,SOFA,SAA,CD64,IL-6,and HBP levels in the control group were lower than those in the severe and general sepsis groups.Logistic regression analysis showed that SII,APACHEⅡ,SOFA,SAA,CD64,IL-6,and HBP were important factors affecting the severity of sepsis(all P<0.05).The combined ROC curve area under the curve(AUC)for IL-6 and HBP in the diagnosis was 0.948.Conclusion The combined detection of IL-6 and HBP has a high diagnostic efficacy for the diagnosis and assessment of sepsis patients.

关 键 词：肝素结合蛋白 白细胞介素6 脓毒血症 受试者工作特征曲线 

分 类 号：R631.2[医药卫生—外科学]