血清中性粒细胞胞外诱捕网水平与脓毒性休克患者病情以及预后的相关性分析

徐海涛; 朱伦刚; 卢安阳; 李娜; 杨朝栋; 黄彬

doi:10.13201/j.issn.1009-5918.2021.11.003

血清中性粒细胞胞外诱捕网水平与脓毒性休克患者病情以及预后的相关性分析

- 电子科技大学医学院附属绵阳医院·绵阳市中心医院急诊医学科(四川绵阳, 621000)
基金项目:
四川省卫生和计划生育科研项目(四川省卫生厅科研基金)(No:19PJ113)

详细信息

通讯作者: 黄彬,E-mail:2012841342@qq.com

中图分类号: R446.11

收稿日期: 2021-08-23

Correlation analysis of serum neutrophil extracellular traps level with the condition and prognosis of patients with septic shock

- Department of Emergency Medicine, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, 621000, China

More Information

Corresponding author: HUANG Bin, E-mail: 2012841342@qq.com

Received Date: 23 August 2021

摘要

摘要: 目的:探讨血清中性粒细胞胞外诱捕网(NETs)水平与脓毒性休克患者病情以及预后的相关性。方法:选择2019年1月-2020年12月期间我院收治的157例脓毒性休克患者,根据APACHEⅡ评分将患者分为0~10分组(46例)、11~20分组(69例)和>20分组(42例),根据SOFA评分分为0~5分组(53例)、6~10分组(71例)和>10分组(33例),根据患者入院28 d内生存情况将患者分为存活组(111例)和死亡组(46例),另选择117例健康志愿者为健康对照组。检测血清NETs水平和凝血指标,分析NETs与凝血指标APACHEⅡ、SOFA评分的相关性,NETs与脓毒性休克患者入院28 d内生存情况的关系以及NETs的预测价值。结果:脓毒性休克组血清NETs水平,凝血酶原时间(PT)、纤维蛋白原(Fib)、D-二聚体、国际标准化比值(INR)均高于健康对照组(P<0.05)。不同APACHEⅡ评分、SOFA评分脓毒性休克患者血清NETs水平差异显组(P<0.05),NETs与APACHEⅡ评(r_s=0.762)、SOFA评分(r_s=0.849)、PT(r=0.772)、Fib(r=0.760)、D-二聚体(r=0.781)、INR(r=0.851)均呈正相关(P<0.05)。高SOFA评分、器官衰竭数量增多、高水平NETs是脓毒性休克患者入院28 d内死亡的危险因素(P<0.05)。NETs预测脓毒性休克患者入院28 d内死亡的曲线下面积为0.802(敏感度为80.43%,特异度为81.98%),与SOFA评分预测效能接近(P>0.05)。结论:脓毒性休克患者血清NETs水平明显升高,NETs升高与脓毒性休克病情加重和院内死亡有关。
- 中性粒细胞胞外诱捕网 /
- 脓毒性休克 /
- 病情严重程度 /
- 预后
Abstract: Objective:To investigate the correlation between serum neutrophil extracellular traps(NETS) level and the condition and prognosis of patients with septic shock.Methods:One hundred and fifty-seven patients with septic shock were selected, and the patients were divided into 0-10 group(46 cases), 11-20 group(69 cases) and>20 group(42 cases) according to APACHE Ⅱ score, and 0-5 group(53 cases), 6-10 group(71 cases) and>10 group(33 cases) according to SOFA score. According to the survival within 28 days after admission, the patients were divided into survival group(111 cases) and death group(46 cases). Another 117 healthy volunteers were selected as the healthy control group. Serum NETS level and coagulation indexes were detected, and the correlation between NETS and coagulation indexes, APACHE Ⅱ and SOFA score, the relationship between NETS and survival of patients with septic shock within 28 days after admission, and the predictive value of NETS were analyzed.Results:The level of serum NETs, prothrombin time(PT), fibrinogen(FIB), D-dimer and international normalized ratio(INR) in septic shock group were higher than those in healthy control group(P<0.05). Different score of APACHE Ⅱ and SOFA showed significant difference in serum NETS level in patients with septic shock(P<0.05). Nets was positively correlated with APACHE Ⅱ rating(r_s=0.762), SOFA score(r_s=0.849), PT(r=0.772), FIB(r=0.760), D-dimer(r=0.781), INR(r=0.851)(P<0.05). High SOFA score, increased number of organ failure, and high level of NETS were risk factors for death of septic shock patients within 28 days after admission(P<0.05). The area under the curve for NETS to predict death in patients with septic shock within 28 days of admission was 0.802(with a sensitivity of 80.43% and a specificity of 81.98%), similar to SOFA score(P>0.05).Conclusion:The level of serum NETs is significantly higher in patients with septic shock, and the increase of NETs is associated with exacerbation of septic shock and in-hospital death.
- neutrophils extracellular trap /
- septic shock /
- severity of illness /
- prognosis

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