| 李尚真,崔云云,张海云,冀乃喜,刘文浩.急诊腹腔感染相关脓毒症患者血清BNP、PCT、SIGIRR变化及与预后的关系[J].,2024,(13):2521-2526 |
| 急诊腹腔感染相关脓毒症患者血清BNP、PCT、SIGIRR变化及与预后的关系 |
| Changes of Serum BNP, PCT and SIGIRR in Patients with Emergency Abdominal Infection-related Sepsis and Relationship with Prognosis |
| 投稿时间：2023-12-24 修订日期：2024-01-18 |
| DOI：10.13241/j.cnki.pmb.2024.13.023 |
| 中文关键词: 腹腔感染 脓毒症 心肌损伤 脑钠肽 降钙素原 |
| 英文关键词: Abdominal infection Sepsis Myocardial injury Brain natriuretic peptide Procalcitonin |
| 基金项目:青海省卫生健康科研课题项目（2021-wjzdx-116） |
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| 中文摘要: |
| 摘要 目的：探究急诊腹腔感染相关脓毒症患者血清脑钠肽（BNP）、降钙素原（PCT）、白介素-1受体相关蛋白（SIGIRR）变化及与预后的关系。方法：将我院于2020年1月-2023年10月接收的318例急诊腹腔感染患者，根据是否发生脓毒症，将其分为单纯感染组（n=233）与脓毒症组（n=85），对比两组患者基线资料、血清BNP、PCT、SIGIRR水平差异，采用Pearson相关分析法探究血清各指标与临床资料相关性。将脓毒症组患者根据其28d内生存情况，分为生存组（n=56）与死亡组（n=29），对比两组患者基线资料、血清BNP、PCT、SIGIRR水平差异，采用二元logistics方程分析影响脓毒症患者预后的相关影响因素；采用ROC曲线分析血清BNP、PCT、SIGIRR水平对脓毒症组预后的诊断价值。结果：单纯感染组与脓毒症组患者病原体种类、WBC、CRP、ALB、APACHEⅡ及SOFA比较差异显著（P＜0.05）；单纯感染组血清BNP、PCT、SIGIRR水平均显著低于脓毒症组（P＜0.05）；Pearson相关性分析显示，脓毒症组患者BNP、PCT、SIGIRR水平与WBC、CRP、APACHEⅡ评分、SOFA评分均呈显著正相关（P<0.05），与ALB呈显著负相关（P<0.05）；脓毒症患者中，死亡组血清BNP、PCT、SIGIRR水平均显著高于生存组（P＜0.05）；二元logistics回归分析显示，血清BNP、PCT及SIGIRR水平均与脓毒症患者不良预后相关（P<0.05）；ROC曲线显示，血清BNP、PCT、SIGIRR单独及联合预测脓毒症患者不良预后的AUC分别为0.876、0.826、0.779、0.976，敏感度为86.21%、82.76%、75.86%、96.55%，特异度为75%、75%、71.43%、69.64%，联合诊断价值更高。结论：BNP、PCT、SIGIRR与腹腔感染相关脓毒症患者具有一定关联性，可作为临床诊治及预后评估参考指标。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the changes of serum brain natriuretic peptide (BNP), procalcitonin (PCT) and recombinant single Ig IL1 related receptor (SIGIRR) in patients with emergency abdominal infection-related sepsis and their relationship with prognosis. Methods: 318 patients with emergency abdominal infection who were received by our hospital from January 2020 to October 2023 were divided into simple infection group (n=233) and sepsis group (n=85) according to whether sepsis occurred. The baseline data and serum BNP, PCT and SIGIRR levels were compared between groups. Pearson correlation analysis was used to explore the correlation between serum indicators and clinical data. The patients in sepsis group were classified into survival group (n=56) and death group (n=29) by means of survival status within 28 days, and the baseline data, serum BNP, PCT and SIGIRR were compared. Binary logistics equation was used to analyze the related influencing factors of prognosis of patients with sepsis. ROC curve was adopted to analyze the diagnostic value of serum BNP, PCT and SIGIRR levels on prognosis of sepsis group. Results: There were significant differences in pathogen types, WBC, CRP, ALB, APACHE II score and SOFA score between simple infection group and sepsis group (P<0.05). The levels of serum BNP, PCT and SIGIRR in simple infection group were significantly lower than those in sepsis group (P<0.05). Pearson correlation analysis showed that the levels of BNP, PCT and SIGIRR in sepsis group were positively correlated with WBC, CRP, APACHE II score and SOFA score (P<0.05), and were negatively correlated with ALB (P<0.05). Among patients with sepsis, the levels of serum BNP, PCT and SIGIRR were significantly higher in death group than those in survival group(P<0.05). Binary logistics regression analysis showed that serum BNP, PCT and SIGIRR levels were associated with poor prognosis in patients with sepsis(P<0.05). ROC curve revealed that the AUCs of serum BNP, PCT, SIGIRR alone and in combination in predicting the poor prognosis in patients with sepsis were 0.876, 0.826, 0.779 and 0.976, the sensitivities were 86.21%, 82.76%, 75.86% and 96.55%, and the specificities were 75%, 75%, 71.43% and 69.64% respectively, and the combined diagnostic value was higher. Conclusion: BNP, PCT and SIGIRR have a certain correlation with patients with abdominal infection-related sepsis, and can be used as reference indicators for clinical diagnosis, treatment and prognosis evaluation. |
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