摘要
目的 探究血清胆碱酯酶(ChE)、血管生成素-1(Ang-1)和白细胞介素-6(IL-6)对感染性休克患者临床结局的预测价值。方法 回顾性分析2019年1月-2021年1月新乡市中心医院重症医学科(ICU)接收的118例感染性休克患者的临床资料,根据28 d死亡情况,分为生存组77例、死亡组41例,统计所有患者确诊48 h内血清ChE、Ang-1和IL-6水平,分析影响感染性休克预后的危险因素以及各指标对感染性休克预后的评估价值。结果 与生存组比较,单因素分析中死亡组感染性休克患者平均年龄大,SOFA评分、谷草转氨酶、总胆红素、血肌酐、IL-6和Ang-1水平升高,而白细胞计数、血小板计数和ChE水平降低(P<0.05)。多因素分析结果显示,年龄、SOFA评分是影响感染性休克患者预后的危险因素(P<0.05)。ROC曲线分析显示,血清ChE、Ang-1和IL-6联合预测感染性休克28 d死亡的AUC为0.903,显著高于单独检测的0.823、0.740、0.714。结论 预后不良的感染性休克患者血清ChE下降,Ang-1、IL-6水平升高,年龄,SOFA评分是感染性休克患者短期预后的危险因素,ChE、Ang-1和IL-6可作为感染性休克患者短期预后的评价指标。
OBJECTIVE To explore the values of serum cholinesterase(ChE), angiopoietin-1(Ang-1) and interleukin-6(IL-6) in prediction of clinical outcomes of the patients with septic shock. METHODS The clinical data of 118 patients with septic shock who were treated in intensive care unit(ICU) of Xinxiang Central Hospital from Jan 2019 to Jan 2021 were retrospectively analyzed. The patients were divided into the survival group with 77 cases and the death group with 41 cases according to the 28-day treatment outcomes.The levels of serum ChE, Ang-1 and IL-6 of all the patients who diagnosed with septic shock within 48 hours were statistically analyzed, the risk factors for the prognosis of the patients with septic shock were analyzed, and the values of the indexes in assessment of prognosis of the septic shock patients were observed. RESULTS Univariate analysis showed that the average age of the septic shock patients was significantly greater in the death group than in the survival group, score of sequential organ failure assessment(SOFA), aspartate aminotransferase level, total bilirubin level, serum creatinine level, IL-6 level and Ang-1 level of the death group were significantly higher than those of the survival group, while the white blood cell counts, platelet counts and ChE level of the death group were significantly lower than those of the survival group(P<0.05). The result of multivariate analysis indicated that age and SOFA score were the risk factors for the prognosis of the patients with septic shock(P<0.05). ROC curve analysis showed that the AUC of the joint detection of serum ChE, Ang-1 and IL-6 was 0.903 in prediction of 28-day mortality of the septic shock patients, remarkably higher than 0.823, 0.740 and 0.714 of the single detection. CONCLUSION The serum ChE level of the septic shock patients with poor prognosis is reduced, the levels of Ang-1 and IL-6 are elevated. The age and SOFA score are the risk factors for short-term prognosis of the patients with septic shock. The ChE, Ang-1 and IL-6 can be used as indexes for evaluation of short-term prognosis of the septic shock patients.
作者
郭战萍
任静静
王珊珊
郭伟伟
石庆玲
陈玉明
GUO Zhan-ping;REN Jing-jing;WANG Shan-shan;GUO Wei-wei;SHI Qing-ling;CHEN Yu-ming(Xinziang Central Hospital,Xinriang,Henan 453000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第5期689-692,共4页
Chinese Journal of Nosocomiology
基金
河南省自然科学基金资助项目(182300410107)。
作者简介
郭战萍(1984-),女,本科,主管技师,研究方向:出凝血与血栓检验。
