血清SAA和sFlt-1及TPS-2在老年脓毒症病情严重程度的相关性分析  

Correlation analysis of serum SAA and sFlt-1 and TPS-2 in severity of sepsis in elderly

作　　者：王小雯[1] 郭丽纳 王会敏 郭海星 石文博 WANG Xiao-wen;GUO Li-na;WANG Hui-min;GUO Hai-xing;SHI Wen-bo(Department of Critical Care Medicine,Zhengzhou Peoples Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州人民医院重症医学科,郑州450000

出　　处：《医药论坛杂志》2025年第2期127-131,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230720)。

摘　　要：目的 探讨血清淀粉样蛋白A(serum amyloid A,SAA)、血清可溶性fms样酪氨酸激酶-1(soluble fms-like tyrosine kinase-1,sFlt-1)、胰蛋白酶原-2(trypsinogen-2,TPS-2)在老年脓毒症中的价值。方法 选取2020年6月至2023年6月期间郑州人民医院收治的老年脓毒症患者120例作为观察组,根据是否发生休克,将观察组患者分为脓毒症休克组(n=76)、脓毒症非休克组(n=44);另纳入同期收治的健康老年人群60例作为对照组,收集患者的临床资料,并对其血清SAA、TPS-2及sFlt-1水平进行比较,采用logistic回归分析分析老年脓毒症发生的相关因素,并采用受试者工作特征(receiver operating characteristic,ROC)曲线分析以上血清指标对老年脓毒症的诊断效能。结果 观察组白细胞计数、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、sFlt-1、SAA及TPS-2水平均较对照组明显偏高(P<0.05)。Logistic回归分析结果显示,血清SAA、TPS-2及sFlt-2水平均是影响老年脓毒症发生的危险因素(P<0.05)。ROC曲线分析结果显示,血清sFlt-1、SAA、TPS-2水平及联合诊断脓毒症的曲线下面积(area under the curve,AUC)分别为0.782(0.676~0.889)、0.809(0.710~0.907)、0.865(0.783~0.947)和0.920(0.862~0.978),其灵敏度分别为62.51%、81.25%、83.34%和93.75%;特异度为85.07%、70.03%、77.42%和77.51%。结论 血清SAA、sFlt-1、TPS-2水平的改变对老年脓毒症的临床诊断有较高的指导价值,三者联合诊断准确性更高。Objective To explore the value of serum amyloid A(SAA),serum soluble fms-like tyrosine kinase-1(sFlt-1) and trypsinogen-2(TPS-2) in elderly sepsis.Methods Totally 120 elderly patients with sepsis admitted to Zhengzhou People's Hospital from June 2020 to June 2023 were selected as the observation group,and the patients in the observation group were divided into septic shock group(n=76) and septic non-shock group(n=44) according to whether there was shock or not.In addition,other 60 healthy elderly people admitted in the same period were taken as the control group,and the clinical data of these groups were collected,and their serum SAA,TPS-2 and sFlt-1 levels were compared.Logistic regression analysis was used to analyze the related factors affecting the occurrence of sepsis in the elderly,and the diagnostic efficacy of the above serum indicators for sepsis in the elderly was analyzed by the receiver operating characteristic(ROC) curve.Results The levels of white blood cell count,total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),sFlt-1,SAA and TPS-2 in the observation group were significantly higher than those in the control group(P<0.05).Logistic regression analysis showed that serum SAA,TPS-2 and sFlt-2 levels were all risk factors for sepsis in the elderly(P<0.05).ROC curve analysis showed that serum sFlt-1,SAA,TPS-2 levels and area under the curve(AUC) of combined diagnosis of SAP were 0.782(0.676-0.889),0.809(0.710-0.907),0.865(0.783-0.947) and 0.920(0.860-0.978),respectively.The sensitivity was 62.51%,81.25%,83.34% and 93.75%,respectively.The specificity was 85.07%,70.03%,77.42% and 77.51%,respectively.Conclusion The changes of serum SAA,sFlt-1 and TPS-2 levels have high guiding value for the clinical diagnosis of sepsis in the elderly,and the combined diagnosis of them is more accurate.

关 键 词：血清淀粉样蛋白A 血清可溶性fms样酪氨酸激酶-1 胰蛋白酶原-2 老年脓毒症 诊断价值 

分 类 号：R459.7[医药卫生—急诊医学]