文章摘要
才 让,陈学梅,祁蕙燕,张 辉,赵 莹.脓毒症患者血清H2S、GDF-15、PTX-3水平与凝血功能、炎症指标及病情评分的相关性分析[J].,2021,(7):1365-1369
脓毒症患者血清H2S、GDF-15、PTX-3水平与凝血功能、炎症指标及病情评分的相关性分析
Correlation Analysis of Serum H2S, GDF-15 and PTX-3 Levels with Coagulation Function, Inflammation Indexes and Disease Score in Sepsis Patients
投稿时间:2020-09-03  修订日期:2020-09-27
DOI:10.13241/j.cnki.pmb.2021.07.036
中文关键词: 脓毒症  硫化氢  生长分化因子-15  穿透素-3  凝血功能  相关性
英文关键词: Sepsis  Hydrogen sulfide  Growth differentiation factor-15  Pentraxin-3  Coagulation function  Correlation
基金项目:青海省自然科学基金项目(2015-ZJ-203)
作者单位E-mail
才 让 西宁市第一人民医院检验科 青海 西宁 810000 caihao20130831@163.com 
陈学梅 西宁市第一人民医院检验科 青海 西宁 810000  
祁蕙燕 西宁市第一人民医院检验科 青海 西宁 810000  
张 辉 西宁市第一人民医院检验科 青海 西宁 810000  
赵 莹 西宁市第一人民医院检验科 青海 西宁 810000  
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中文摘要:
      摘要 目的:探讨脓毒症患者血清硫化氢(H2S)、生长分化因子-15(GDF-15)、穿透素-3(PTX-3)水平与其凝血功能、炎症指标及病情评分的相关性。方法:随机选取我院2018年2月~2020年2月收治的脓毒症患者52例作为脓毒症组,另选取我院同期收治的脓毒症休克患者46例作为休克组以及同期于我院进行体检的健康者50例作为对照组。检测三组血清H2S、GDF-15、PTX-3水平以及凝血功能、炎症指标,其中凝血功能指标包括血小板计数(PLT)、部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)。炎症指标包括降钙素原(PCT)、C反应蛋白(CRP)。采用急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)、快速序贯器官功能(qSOFA)评分对脓毒症组、休克组患者病情进行评分。分析血清H2S、GDF-15、PTX-3与患者凝血功能、炎症指标及病情评分的相关性。结果:脓毒症组、休克组的血清H2S、PLT均低于对照组,且休克组低于脓毒症组(P<0.05)。脓毒症组、休克组的血清GDF-15、PTX-3、APTT、PT、FIB、PCT、CRP均高于对照组,且休克组高于脓毒症组(P<0.05)。脓毒症组APACHEⅡ、qSOFA评分均显著低于休克组(P<0.05)。血清H2S与PLT呈正相关(P<0.05),与APTT、PT、FIB、PCT、CRP、APACHEⅡ评分、qSOFA评分呈负相关(P<0.05)。血清GDF-15、PTX-3与PLT呈负相关(P<0.05),与APTT、PT、FIB、PCT、CRP、APACHEⅡ评分、qSOFA评分呈正相关(P<0.05)。结论:脓毒症患者的血清H2S明显下降,而血清GDF-15、PTX-3增高,三者与凝血功能、炎症以及病情评分均存在密切关联,这可能是影响脓毒症进展的重要原因之一。
英文摘要:
      ABSTRACT Objective: To explore the correlation of serum hydrogen sulfide (H2S), growth differentiation factor-15 (GDF-15), Pentraxin-3 (PTX-3) levels with blood coagulation function, inflammation indexes and disease score in sepsis patients. Methods: 52 cases of sepsis patients admitted to our hospital from February 2018 to February 2020 were randomly selected as the sepsis group, and 46 cases of septic shock patients admitted to the same period were selected as the shock group, at the same time, 50 healthy people who had physical examination in our hospital were taken as control group. Serum H2S, GDF-15, PTX-3 levels, coagulation function and inflammation indexes were detected in the three groups of subjects. The coagulation function indexes include platelet count (PLT), activited partial thomboplastin time (APTT), prothrombin time (PT), and fibrinogen (FIB). Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), Quick sequential organ failure assessment (qSOFA) were used to score the patients in the sepsis group and shock group. The correlation of serum H2S, GDF-15, PTX-3 with patients' coagulation function, inflammation indexes and disease score were analyzed. Results: The serum H2S, PLT in the sepsis group and shock group were lower than that in the control group, and the shock group was lower than the sepsis group (P<0.05). Serum GDF-15, PTX-3, APTT, PT, FIB, PCT, CRP in the sepsis group and shock group were higher than those in the control group, and the shock group was higher than the sepsis group (P<0.05). The scores of APACHEⅡ and qSOFA in the sepsis group were significantly lower than those in the shock group (P<0.05). Serum H2S was positively correlated with PLT (P<0.05), and negatively correlated with APTT, PT, FIB, PCT, CRP, APACHE II score, qSOFA score (P<0.05). Serum GDF-15, PTX-3 were negatively correlated with PLT (P<0.05), and positively correlated with APTT, PT, FIB, PCT, CRP, APACHE II score, qSOFA score (P<0.05). Conclusion: Serum H2S in sepsis patients was significantly down-regulated, while serum GDF-15 and PTX-3 are increased. The three are closely related to coagulation function, inflammation and disease score, which may be an important reason for the progress of sepsis.
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