脓毒症患者血清HBP水平与常规炎症标志物相关性及联合HBP清除率对不良预后的预测价值

徐策; 葛新; 宦陟榕

doi:10.13201/j.issn.1009-5918.2021.09.003

脓毒症患者血清HBP水平与常规炎症标志物相关性及联合HBP清除率对不良预后的预测价值

- 无锡市第九人民医院ICU(江苏无锡,214000)
基金项目:
江苏省卫生健康委2020年度医学科研立项项目(No:M2020A004)

详细信息

通讯作者: 徐策,E-mail:shaobachengshi4@163.com

中图分类号: R631.2

收稿日期: 2021-05-22

Correlation between serum HBP level and conventional inflammatory markers in patients with sepsis and the predictive value of combined HBP clearance rate for poor prognosis

- Department of Intensive Care Unit, Wuxi 9th People's Hospital, Wuxi, Jiangsu, 214000, China

More Information

Corresponding author: XU Ce, E-mail: shaobachengshi4@163.com

Received Date: 22 May 2021

摘要

摘要: 目的:分析脓毒症患者血清肝素结合蛋白(HBP)水平与常规炎症标志物的相关性及联合HBP清除率对不良预后的预测价值。方法:收集我院2020年1月-2021年1月期间收治的106例脓毒症患者,根据治疗后28 d存活情况分为存活组和死亡组,比较两组的一般资料、病情程度评分、血常规指标、肝肾功能指标、凝血功能、炎症标志物及血清HBP、HBP 24 h清除率。采用Pearson相关法分析血清CRP、PCT与HBP、HBP 24 h清除率的相关性。采用多因素Logistic回归分析确定预后的影响因素,绘制CRP、PCT与HBP 24 h清除率及三者联合预测预后的ROC曲线。结果:106例脓毒症患者的28 d病死率为23.58%(25/106)。死亡组APACHEⅡ评分、SOFA评分、SCr、D-二聚体、CRP、PCT、HBP高于存活组,HBP 24 h清除率低于存活组(P<0.05)。血清HBP与CRP、PCT呈正相关,HBP 24 h清除率与CRP、PCT呈负相关(P<0.05)。多因素Logistic回归分析显示,APACHEⅡ评分(OR=1.659,95%CI:1.038-2.652)、SOFA评分(OR=2.521,95%CI:1.482-4.288)、CRP(OR=2.447,95%CI:1.334-4.489)、PCT(OR=3.117,95%CI:1.524-6.375)、HBP 24 h清除率(OR=0.361,95%CI:0.164-0.795)是脓毒症患者的预后影响因素(P<0.05)。HBP 24 h清除率联合血清CRP、PCT预测预后的ROC曲线下面积最高达0.923(95%CI:0.853-0.993),敏感度与特异度分别为0.915、0.821。结论:APACHEⅡ评分、SOFA评分、CRP、PCT、HBP 24 h清除率是脓毒症患者的预后影响因素,且血清CRP、PCT与HBP有明显相关性。血清CRP、PCT联合HBP 24 h清除率预测脓毒症患者预后具有更高的敏感度。
- 脓毒症 /
- 肝素结合蛋白 /
- 清除率 /
- 预后 /
- 预测价值
Abstract: Objective: To analyze the correlation between serum heparin-binding protein(HBP) levels and conventional inflammatory markers in patients with sepsis, and the predictive value of combined HBP clearance rate on poor prognosis.Methods: A total of 106 sepsis patients admitted to Wuxi Ninth People's Hospital from January 2020 to January 2021 were selected and divided into survival group and death group according to their prognosis at 28 days after treatment. The general information, disease severity scores, blood routine indicators, liver and kidney function indexes, blood coagulation function, inflammation markers, serum HBP and HBP clearance rate in 24 hours of the two groups were compared. Pearson correlation method was used to analyze the correlation between serum CRP, PCT and HBP, HBP 24 h clearance rate. Multivariate Logistic regression analysis was used to determine the prognostic factors, and the ROC curves of CRP, PCT and HBP 24 h clearance rate and the combination of the three to predict the prognosis were drawn.Results: The 28-day case fatality rate of 106 sepsis patients was 23.58%(25/106). The APACHEⅡ score, SOFA score, SCr, DD, CRP, PCT, HBP of the death group were higher than those of the survival group, and the 24-hour clearance rate of HBP of the death group was lower than that of the survival group(P<0.05). Serum HBP was positively correlated with CRP and PCT, and the 24 h clearance rate of HBP was negatively correlated with CRP and PCT(P<0.05). Multivariate Logistic regression analysis showed that APACHEⅡ score(OR=1.659, 95%CI: 1.038-2.652), SOFA score(OR=2.521, 95%CI: 1.482-4.288), CRP(OR=2.447, 95%CI: 1.334-4.489), PCT(OR=3.117, 95%CI: 1.524-6.375), HBP 24-hour clearance rate(OR=0.361, 95%CI: 0.164-0.795) were the prognostic factors of patients with sepsis(P<0.05). The area under the ROC curve for the 24-hour clearance rate of HBP combined with serum CRP and PCT to predict prognosis was up to 0.923(95%CI: 0.853 to 0.993), and the sensitivity and specificity were 0.915 and 0.821,respectively.Conclusion: APACHEⅡ score, SOFA score, CRP, PCT, HBP 24 h clearance are the prognostic factors of patients with sepsis, and there is a significant correlation between serum CRP, PCT and HBP. The combination of serum CRP, PCT and HBP 24 h clearance rate has higher sensitivity to predict the prognosis of patients with sepsis.
- sepsis /
- heparin binding protein /
- clearance rate /
- prognosis /
- predictive value

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