摘要
目的探讨半胱氨酸天冬氨酸蛋白酶12(Capase-12)、半胱氨酸天冬氨酸蛋白酶3(Capase-3)、死亡相关蛋白激酶1(DAPK1)对重症脓毒症患者感染性休克的预测价值。方法选取2020年4月—2023年4月本院收治的90例重症脓毒症患者设为观察组,同期本院90例体检健康者设为对照组。比较两组血清Capase-12、Capase-3、DAPK1水平,观察组患者根据是否发生感染性休克将其分为感染性休克组(n=23)、非感染性休克组(n=67),比较两组血清Capase-12、Capase-3、DAPK1水平,绘制受试者工作曲线(ROC),计算曲线下面积(AUC),分析血清Capase-12、Capase-3、DAPK1对感染性休克的预测效能。单因素、多因素Logistic回归分析感染性休克发生的危险因素。结果观察组血清Capase-12、Capase-3、DAPK1水平均高于对照组(P<0.05)。感染性休克组血清Capase-12、Capase-3、DAPK1水平均高于非感染性休克组(P<0.05)。血清Capase-12、Capase-3、DAPK1联合检测诊断感染性休克的AUC是0.863,95%CI 0.768~0.952,灵敏度(95.28%)、特异度(90.76%)均高于单一检测(78.19%、72.82%)、(75.12%、70.34%)、(72.67%、68.19%)(P<0.05)。Logistic回归分析显示,血清Capase-12、Capase-3、DAPK1、器官衰竭数量、低蛋白血症、血容量不足、血清PCT是诱发感染性休克的危险因素(P<0.05)。结论血清Capase-12、Capase-3、DAPK1水平异常高表达与重症脓毒症患者感染性休克的发生有着极为密切的联系,联合检测可提高对感染性休克的预测效能,感染性休克的发生与多种因素有关,应当引起临床重视与关注。
Objective To analyze the predictive value of cysteine aspartic protease 12(Capase-12),cysteine aspartic protease 3(Capase-3)and death related protein kinase 1(DAPK1)in septic shock in patients with severe sepsis.Methods Ninety patients with severe sepsis treated in our hospital from April 2020 to April 2023 were selected as the observation group,and 90 healthy subjects in our hospital during the same period were selected as the control group.Serum levels of Capase-12,Capase-3 and DAPK1 were compared between the two groups.Observation group was divided into septic shock group(23 cases)and non-septic shock group(67 cases)according to whether septic shock occurred.Serum levels of Capase-12,Capase-3 and DAPK1 were compared between the two groups,receiver operating curve(ROC)was plotted,and area under the curve(AUC)was calculated.To analyze the predictive efficacy of serum Capase-12,Capase-3 and DAPK1 on septic shock.The risk factors of septic shock were analyzed by univariate and multivariate logistic regression.Results The levels of Capase-12,Capase-3 and DAPK1 in the observation group were higher than those in the control group(P<0.05).The serum levels of Capase-12,Capase-3 and DAPK1 in septic shock group were higher than those in non-septic shock group(P<0.05).The AUC for the combined detection of serum Capase-12,Capase-3,and DAPK1 in the diagnosis of septic shock was 0.863,and the 95%CI was 0.768-0.952.The sensitivity(95.28%)and specificity(90.76%)were higher than those of single detection(78.19%,72.82%),(75.12%,70.34%),(72.67%,68.19%)(P<0.05).Logistic regression analysis showed that serum Capase-12,Capase-3,DAPK1,number of organ failure,hypoproteinemia,hypovolemia and serum PCT were risk factors for septic shock(P<0.05).Conclusion Abnormal high levels of Capase-12,Capase-3 and DAPK1 in serum are closely related to the occurrence of septic shock in patients with severe sepsis.Combined detection can improve the predictive efficacy of septic shock.The occurrence of septic shock is related to many factors and should be paid attention to in clinic.
作者
邓亮飞
李敏
吴嘉帆
李丽
刘建雄
钟燕军
DENG Liangfei;LI Min;WU Jiafan;LI Li;LIU Jianxiong;ZHONG Yanjun(The Affiliated Hospital of Xiangnan University,Chenzhou 423000,Hunan,China)
出处
《西部医学》
2024年第11期1625-1630,共6页
Medical Journal of West China
基金
国家自然科学基金青年科学基金项目(81701962)
郴州市科学技术局技术研发中心项目(20201517)。
作者简介
通讯作者:李敏,E-mail:dengliangfei198808@163.com。
