毛细血管渗漏指数联合补体C3对儿童脓毒症早期预后的预测价值  

Predictive value of capillary leakage index combined with complement C3 in the early prognosis of sepsis in children

作　　者：叶国静 黄海忠[1] 张红[1] 邓国雄[1] 谢培林 王静 YE Guojing;HUANG Haizhong;ZHANG Hong;DENG Guoxiong;XIE Peilin;WANG Jing(Department of Pediatrics,the Third People’s Hospital of Huizhou City,Guangdong Province,Huizhou 516002,China)

机构地区：[1]广东省惠州市第三人民医院儿科,广东惠州516002

出　　处：《妇儿健康导刊》2024年第24期195-198,F0003,共5页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的探讨毛细血管渗漏指数(CLI)联合补体C3对脓毒症患儿早期预后的预测价值。方法回顾性分析2021年12月至2023年10月惠州市第三人民医院收治的50例脓毒症患儿,按照病情严重程度分为一般脓毒症组(n=32)和脓毒性休克组(n=18)。比较两组CLI、补体C3,分析补体C3、CLI与序贯器官功能衰竭(SOFA)评分的关系,单因素、多因素分析脓毒症患儿早期预后的影响因素,采用受试者操作特征(ROC)曲线分析CLI和补体C3对脓毒症不良预后的预测作用。结果脓毒性休克组的CLI高于一般脓毒症组,补体C3低于一般脓毒症组(P<0.05)。补体C3与SOFA评分呈负相关(r=-0.52,P<0.001),CLI与SOFA评分呈正相关(r=0.49,P<0.001)。脓毒症患儿预后不良发生率为42.00%。多因素logistic分析显示,CLI、SOFA、补体C3和Th/Ts是脓毒症预后不良的独立预测因素(P<0.05)。ROC曲线分析显示,补体C3联合CLI预测不良预后的曲线下面积为0.874(95%CI:0.847~0.942),约登指数为0.778,预测价值高于单项指标(P<0.05)。结论脓毒症患儿C3、CLI水平明显升高,可作为脓毒症预后评价的指标,且两者联合具有较高的预测价值。Objective To explore the value of capillary leakage index(CLI)combined with complement C3 in predicting the early prognosis of sepsis in children.Methods A retrospective analysis was performed on 50 children with sepsis who were admitted to the Third People’s Hospital of Huizhou City from December 2021 to October 2023 and divided into general sepsis group(n=32)and septic shock group(n=18)according to the severity of the disease.The CLI and complement C3 between the two groups were compared,and the relationship between CLI,complement C3 and sequential organ failure assessment(SOFA)score was analyzed.The influencing factors of early prognosis in children with sepsis were analyzed by univariate and multifactorial analysis,and the predictive role of CLI and complement C3 on poor prognosis in sepsis was analyzed using receiver operator characteristic(ROC)curve.Results The septic shock group had higher CLI and lower complement C3 than the general sepsis group(P<0.05).The complement C3 was negatively correlated with SOFA score(r=-0.52,P<0.001),while CLI was positively correlated with SOFA score(r=0.49,P<0.001).The incidence rate of poor prognosis in sepsis was 42.00%.Multifactorial logistic analysis showed that the CLI,SOFA,complement C3,and Th/Ts were independent predictors of poor prognosis in sepsis(P<0.05).ROC curve showed that the area under the curve of complement C3 combined w ith CLI for predicting poor prognos is was 0.874(95%CI:0.847-0.942),and the Youden index was 0.778.The combined predictive value was higher than that of each index alone(P<0.05).Conclusion There are significant increases in the levels of C3 and CLI in children with sepsis,which can be used as indicators for the prognosis evaluation of sepsis,and their combination has a higher predictive value.

关 键 词：补体C3 毛细血管渗漏指数 脓毒症 

分 类 号：R729[医药卫生—儿科]