摘要
目的分析血清睾酮(T)、雌二醇(E_(2))与多发伤患者病情严重程度的关系及对多器官功能障碍综合征预测效能研究。方法选择本院自2019年1月-2021年1月接诊的153例多发伤患者作为研究对象,根据损伤严重度评分(ISS评分)分为A组(ISS评分≤16分,68例)、B组(16分<ISS评分≤25分,51例)、C组(25分<ISS评分,34例);比较各组的一般资料、血清降钙素原(PCT)、白介素6(IL)-6、C反应蛋白(CRP)、肿瘤坏死因子α(TNF)-α、T、E_(2)水平,使用受试者工作特征曲线(ROC)下面积(AUC)血清T联合E_(2)对多器官功能障碍综合征预测效能。结果多发伤患者ISS评分越高,血清PCT、IL-6、CRP、TNF-α、E_(2)水平越高,T水平越低,组间两两比较,差异均有统计学意义(P<0.05);经Pearson法分析,多发伤患者ISS评分与血清T水平呈负相关,与E_(2)水平呈正相关(r分别为0.725、0.612,P值均为0.000);经多因素Logistic回归分析,血清PCT、IL-6、CRP、T、E_(2)均是多发伤患者发生多器官功能障碍综合征的独立影响因素(P<0.05);经ROC曲线分析,血清T联合E_(2)预测多发伤患者发生多器官功能障碍综合征的AUC为0.915,明显大于PCT的0.682、IL-6的0.704和CRP的0.653,差异均有统计学意义(P<0.05)。结论多发伤患者血清T、E_(2)均与病情严重程度相关,两者联合预测多器官功能障碍综合征发生的效能较好,可能与高水平T和低水平E_(2)具有器官保护作用有关,值得临床予以重视应用。
Objective To analyze the relationship between serum testosterone(T),estradiol(E_(2))and the severity of multiple injuries and to predict the efficacy of multiple organ dysfunction syndrome.Methods A total of 153 patients with multiple injuries who were admitted to our hospital from January 2019 to January 2021 were selected as the research objects,according to the injury severity score(ISS score),it was divided into group A(ISS score≤16 points,68 cases),group B(16points<ISS score≤25points,51cases),and group C(25 points<ISS score,34 cases);compare general information,serum procalcitonin(PCT),and interleukin 6(IL)of each group-6,C-reactive protein(CRP),tumor necrosis factorα(TNF)-α,T,E_(2)levels,using the area under the receiver operating characteristic curve(ROC)area(AUC)serum T combined with E_(2)for comprehensive multi-organ dysfunction synthesis Sign prediction performance.Results The higher the ISS score in patients with multiple injuries,the higher the serum PCT,IL-6,CRP,TNF-α,and E_(2)levels,and the lower the T level,the comparison between groups is statistically significant(P<0.05);analysis by Pearson method showed that the ISS score of patients with multiple injuries is negatively correlated with serum T level and positively correlated with E_(2)level(r are 0.725 and 0.612,P values are 0.000);by multivariate logistic regression analysis,serum PCT,IL-6,CRP,T,and E_(2)are independent factors affecting multiple organ dysfunction syndrome in patients with multiple injuries(P<0.05);According to ROC curve analysis,the AUC of serum T combined with E_(2)to predict multiple organ dysfunction syndrome in patients with multiple injuries is 0.915,which is significantly greater than that of PCT 0.682,IL-60.704 and CRP 0.653,and the differences are statistically significant(P<0.05).Conclusion Serum T and E_(2)in patients with multiple injuries are both related to the severity of the disease,the combination of the two is more effective in predicting the occurrence of multiple organ dysfunction syndrome,which may be related to the protective effect of high T and low E_(2)levels,which deserves clinical attention.application.
作者
姚旭
Yao Xu(Department of Critical Care Medicine,Friendship Hospital of Urumqi,Urumqi,830049,China)
出处
《新疆医学》
2022年第11期1309-1312,1323,共5页
Xinjiang Medical Journal
关键词
多发伤
睾酮
雌二醇
损伤严重度评分
多器官功能障碍综合征
multiple injuries
testosterone
estradiol
injury severity score
multiple organ dysfunction syndrome
作者简介
姚旭,男,主治医师,研究方向:重症医学。
