ICU烧伤感染患者并发脓毒症的临床特征及sCD163、Presepsin、GPBB诊断价值  

Clinical characteristics of ICU burn wound infection patients with sepsis and diagnostic values of sCD163,Presepsin and GPBB

作　　者：李欣[1] 王浩[1] 侯小倩[1] LI Xin;WANG Hao;HOU Xiao-qian(Cangzhou Central Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市中心医院烧伤整形外科,河北沧州061000

出　　处：《中华医院感染学杂志》2025年第2期225-229,共5页Chinese Journal of Nosocomiology

基　　金：河北省医学科学研究计划项目(20210565);沧州市科技支撑计划项目(183302058)。

摘　　要：目的探讨重症监护室(ICU)烧伤感染患者发生脓毒症的临床特征及可溶性血红蛋白清道夫受体(sCD163)、可溶性CD14分子亚型(Presepsin)、糖原磷酸化酶同工酶BB(GPBB)预测价值。为临床有效诊治ICU烧伤感染后脓毒症提供指导。方法选取2020年12月—2023年10月沧州市中心医院收治的60例发生脓毒症的ICU烧伤感染患者为脓毒症组,另纳入80例未发生脓毒症的ICU烧伤感染患者为非脓毒症组,分析ICU烧伤感染后脓毒症临床特征及病原菌分布,采用受试者工作特征(ROC)曲线分析sCD163、Presepsin、GPBB对ICU烧伤感染患者发生脓毒症的预测价值。结果60例脓毒症组患者创面分泌物共分离64株病原菌,革兰阳性菌占比42.19%,革兰阴性菌占比54.69%,真菌占比3.13%。脓毒症组与非脓毒症组患者烧伤面积及吸入性损伤、休克的患者占比比较有统计学意义(P<0.05),其中脓毒症组患者烧伤面积(62.65±9.65)%及吸入性损伤、休克的患者占比(78.33%、13.33%)较高。脓毒症组和非脓毒症组患者sCD163、Presepsin、GPBB水平比较有统计学意义(P<0.05),其中脓毒症组患者血清sCD163、Presepsin、GPBB水平较高,数值分别为(92.65±17.65)U/ml、(875.54±120.76)pg/ml、(24.65±8.76)ng/ml。sCD163、Presepsin、GPBB联合检测诊断ICU烧伤感染患者发生脓毒症的曲线下面积(AUC)为0.968,敏感度和特异度分别为88.33%和95.00%。结论ICU烧伤感染后脓毒症患者创面分泌物中革兰阴性菌占比较高,烧伤面积、吸入性损伤、休克与ICU烧伤感染患者脓毒症的发生存在一定联系,sC D163、Presepsin、GPBB表达对脓毒症具有较高的诊断价值。OBJECTIVE To explore the clinical characteristics of the burn wound infection patients with sepsis in intensive care unit(ICU)and analyze the diagnostic values of soluble hemoglobin scavenger receptor(sCD163),soluble CD14 molecular subtype(Presepsin)and glycogen phosphorylase isoenzyme BB(GPBB)so as to provide guidance for effective clinical diagnosis and treatment of the ICU burn wound infection patients with sepsis.METHODS A total of 60 ICU burn wound infection patients with sepsis who were treated in Cangzhou Central Hospital from Dec.2020 to Oct.2023 were assigned as the sepsis group,meanwhile,80 ICU burn wound infection patients who did not have sepsis were chosen as the non-sepsis group.The clinical characteristics of the burn wound infection patients with sepsis and distribution of pathogens were observed.The values of sCD163,Presepsin and GPBB in prediction of sepsis of the ICU burn wound infection patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Totally 64 strains of pathogens were isolated from 60 patients of the sepsis group,42.19%of which were gram-positive bacteria,54.69%were gram-negative bacteria,and 3.13%were fungi.There were significant differences in the burn surface area and proportions of patients with inhalation injury and shock between the sepsis group and the non-sepsis group(P<0.05);the burn surface area,the proportion of patients with inhalation injury and the proportion of patients with shock of the sepsis group were respectively(62.65±9.65)%,78.33%and 13.33%,higher than those of the non-sepsis group.There were significant differences in the levels of sCD163,Presepsin and GPBB between the sepsis group and the non-sepsis group(P<0.05);the levels of serum sCD163,Presepsin and GPBB of the sepsis group were respectively(92.65±17.65)U/ml,(875.54±120.76)pg/ml and(24.65±8.76)ng/ml,higher than those of the non-sepsis group.The area under the curve of the joint detection of sCD163,Presepsin and GPBB was 0.968 in diagnosis of the sepsis in the ICU patient

关 键 词：重症监护室 烧伤感染 脓毒症 临床特征 可溶性血红蛋白清道夫受体 可溶性CD14分子亚型 糖原磷酸化酶同工酶BB 诊断价值 

分 类 号：R644[医药卫生—外科学]