血清正五聚蛋白3、可溶性白细胞分化抗原14检测对糖尿病酮症酸中毒合并细菌感染的预测价值  

Predictive value of serum PTX3 and s sCD14 levels for diabetic ketoacidosis complicated with bacterial infection

作　　者：李世平 范平平 吝新英 LI Shiping;FAN Pingping;LIN Xinying(Department of Emergency,Zhangjiakou First Hospital,Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院急诊科,河北张家口075000

出　　处：《陕西医学杂志》2025年第3期394-398,403,共6页Shaanxi Medical Journal

基　　金：河北省医学科学研究课题(20221601);河北省张家口市重点研发计划项目(2221228D)。

摘　　要：目的:探讨血清正五聚蛋白3(PTX3)和可溶性白细胞分化抗原14(sCD14)水平检测对糖尿病酮症酸中毒(DKA)合并细菌感染的预测价值。方法:选取DKA合并细菌感染患者116例为DKA合并感染组,选取DKA未合并感染者115例为DKA未合并感染组。入院后24 h内收集临床资料并进行实验室生化指标检测。采用酶联免疫吸附法(ELISA)检测入院后24 h内和治疗后血清PTX3、sCD14水平,分析DKA合并细菌感染患者入院后24 h内血清PTX3、sCD14与序贯器官衰竭评估(SOFA)评分、急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分、白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)的相关性,DKA合并细菌感染的影响因素,以及入院后24 h内血清PTX3和sCD14水平对DKA合并细菌感染的预测价值。结果:DKA合并感染组入院后24 h内SOFA评分、APACHEⅡ评分、WBC、CRP、PCT、PTX3、sCD14水平高于DKA未合并感染组(均P<0.05)。两组治疗后血清PTX3、sCD14水平较入院后24 h内降低(均P<0.05)。DKA合并细菌感染患者入院后24 h内血清PTX3和sCD14水平与SOFA评分、APACHEⅡ评分、WBC、CRP、PCT呈正相关,且血清PTX3和sCD14水平呈正相关(均P<0.05)。入院后24 h内SOFA评分、APACHEⅡ评分、WBC、CRP、PCT、PTX3、sCD14是DKA患者合并细菌感染的独立危险因素(均P<0.05)。入院后24 h内血清PTX3、sCD14联合预测DKA合并细菌感染的曲线下面积(AUC)大于单项(均P<0.05)。结论:DKA合并细菌感染患者入院后24 h内血清PTX3和sCD14水平升高,两项联合检测对DKA合并细菌感染具有较高的预测价值。Objective:To investigate the predictive value of serum pentraxin 3(PTX3)and soluble leukocyte differentiation antigen 14(sCD14)levels for bacterial infection in patients with diabetic ketoacidosis(DKA).Methods:A total of 116 DKA patients complicated with bacterial infection were enrolled as DKA co-infected group,and 115 DKA patients without bacterial infection were enrolled as DKA non-infection group.Clinical data were collected and laboratory biochemical indexes were detected within 24 hours after admission.Serum levels of PTX3 and sCD14 within 24 hours after admission and after treatment were detected by ELISA.The correlations of serum PTX3 and sCD14 with SOFA score,APACHEⅡscore,WBC,CRP and PCT within 24 hours after admission in DKA patients complicated with bacterial infection,and the influencing factors of DKA complicated with bacterial infection,and the predictive value of serum PTX3 and sCD14 levels within 24 hours after admission for DKA complicated with bacterial infection were analyzed.Results:The levels of SOFA score,APACHEⅡscore,WBC,CRP,PCT,PTX3 and sCD14 in DKA co-infected group were significantly higher than those in DKA non-infection group within 24 hours after admission(all P<0.05).The levels of serum PTX3 and sCD14 in both groups after treatment were significantly lower than those in within 24 hours after admission(all P<0.05).The levels of serum PTX3 and sCD14 in DKA patients complicated with bacterial infection were positively correlated with SOFA score,APACHEⅡscore,WBC,CRP and PCT within 24 hours after admission,and the levels of serum PTX3 and sCD14 were positively correlated(all P<0.05).SOFA score,APACHEⅡscore,WBC,CRP,PCT,PTX3 and sCD14 within 24 hours after admission were independent risk factors for DKA patients complicated with bacterial infection(all P<0.05).Within 24 hours after admission,the AUC of the combination of serum PTX3 and sCD14 in predicting DKA complicated with bacterial infection was larger than that of each item alone(all P<0.05).Conclusion:Serum PTX3 and sCD14 leve

关 键 词：糖尿病酮症酸中毒 细菌感染 正五聚蛋白3 可溶性白细胞分化抗原14 相关性 影响因素 预测价值 

分 类 号：R578.2[医药卫生—消化系统]