血浆肝素结合蛋白、白细胞介素-6和降钙素原对脓毒症休克早期预判的临床价值  

Clinical value of plasma heparin-binding protein,interleukin-6 and procalcitonin in the early prediction of septic shock

作　　者：马郡 杨旭峰[1] MA Jun;YANG Xufeng(Department of Clinical Laboratory,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang 310009,China)

机构地区：[1]浙江大学医学院附属第二医院检验科,浙江杭州310009

出　　处：《医药前沿》2025年第1期55-58,62,共5页Journal of Frontiers of Medicine

摘　　要：目的探讨血浆肝素结合蛋白(HBP)、白细胞介素-6(IL-6)和降钙素原(PCT)对脓毒症进展为脓毒症休克的早期预判价值。方法选取2022年1月—2023年12月在浙江大学医学院附属第二医院治疗的177例脓毒症患者为研究对象,依据入院6 h内是否发生休克将其分为休克组和未休克组。比较两组血浆HBP、IL-6和PCT差异,绘制受试者工作特征曲线分析各指标对脓毒症进展为脓毒症休克的预测价值,采用二分类Logistic回归分析探讨脓毒症进展为脓毒症休克的影响因素。结果休克组血浆HBP、IL-6、PCT高于未休克组,差异有统计学意义(P<0.05)。HBP、IL-6、PCT及三项联合检测预测脓毒症进展为脓毒症休克的敏感度、特异度分别为35.0%和89.7%、78.8%和60.8%、67.5%和53.6%、67.5%和68.0%。HBP、PCT、IL-6及三项联合检测早期预判脓毒症进展为脓毒症休克的曲线下面积分别为0.589、0.598、0.663和0.717。将脓毒症是否进展为脓毒症休克作为因变量,将HBP、PCT和IL-6早期预判脓毒症休克的最佳截断值作为临界值,进行二分类Logistic回归分析,结果显示HBP和IL-6为脓毒症进展为脓毒症休克的影响因素(P<0.05)。结论血浆HBP、PCT和IL-6对脓毒症进展为脓毒症休克有早期预判价值,三项联合检测预判价值更高,HBP和IL-6是脓毒症进展为脓毒症休克的影响因素。Objective To investigate the early prediction value of heparin-binding protein(HBP),interleukin-6(IL-6)and procalcitonin(PCT)in the progression of sepsis to septic shock.Methods A total of 177 patients with sepsis who were treated in the Second Affiliated Hospital,Zhejiang University School of Medicine from January 2022 to December 2023 were selected as the study subjects.According to whether shock occurred within 6 hours after admission,they were divided into shock group and non-shock group.The differences of HBP,IL-6 and PCT between the two groups were compared.The predictive value of each indicater for the progression of sepsis to septic shock was analyzed by drawing the receiver operating characteristic curve.Binary Logistic regression analysis was used to explore the influencing factors of sepsis progression to septic shock.Results The plasma HBP,IL-6 and PCT in the shock group were significantly higher than those in the non-shock group,and the differences were statistically significant(P<0.05).The sensitivity and specificity of HBP,IL-6,PCT and three combined tests in predicting the progression of sepsis to septic shock were 35.0%and 89.7%,78.8%and 60.8%,67.5%and 53.6%,67.5%and 68.0%,respectively.The area under the curve of HBP,PCT,IL-6 and three combined tests for early identification of sepsis progression to septic shock was 0.589,0.598,0.663 and 0.717,respectively.The progression of sepsis was early predicted as septic shock as the dependent variable,and the optimal cut-off values of HBP,PCT and IL-6 for early prediction of septic shock were selected as the critical values for binary Logistic regression analysis.The results showed that HBP and IL-6 were influencing factors for sepsis progression to be early predicted as septic shock(P<0.05).Conclusions Plasma HBP,PCT and IL-6 have clinical value for early prediction of sepsis progression to septic shock,the combined detection of the three has higher predictive value.HBP and IL-6 are the influencing factors for the progression of sepsis to septic shock.

关 键 词：脓毒症 脓毒症休克 肝素结合蛋白 白细胞介素-6 血浆降钙素原 早期预判 

分 类 号：R541[医药卫生—心血管疾病]