摘要
目的探讨血清丙酮酸激酶M2(PKM2)与降钙素原(PCT)对脓毒症的诊断价值。方法选取2022年4月—2023年1月武汉大学人民医院重症监护室(ICU)收治的脓毒症患者119例(脓毒症组),同期入住重症监护室的非脓毒症患者73例(非脓毒症组)作为研究对象。入院24 h内检测并比较2组患者血清PKM2和PCT水平,采用Spearman相关性检验分析脓毒症患者血清PKM2与PCT水平的相关性;采用多因素Logistic回归模型分析各指标对脓毒症发生的影响;绘制受试者工作特征(ROC)曲线评价血清PKM2、PCT及二者联合对脓毒症的诊断价值,并计算曲线下面积(AUC)。结果与非脓毒症组比较,脓毒症组血清PKM2、PCT水平明显升高(Z/P=9.373/<0.001、9.013/<0.001)。脓毒症患者血清PKM2与PCT水平呈正相关(r=0.322,P<0.001)。多因素Logistic回归分析显示,血清PKM2、PCT水平升高均是脓毒症发生的独立危险因素[OR(95%CI)=1.182(1.078~1.295)、1.582(1.186~2.110)]。ROC曲线显示,血清PKM2、PCT及二者联合诊断脓毒症的AUC分别为0.903、0.888、0.941,敏感度分别为0.863、0.918、0.932,特异度分别为0.798、0.748、0.857,二者联合诊断的效能显著高于单独检测(Z/P=2.560/0.011、3.423/<0.001)。结论脓毒症患者血清PKM2水平升高,是脓毒症发生的独立危险因素,并与PCT呈正相关,二者联合检测具有较高诊断价值。
Objective To explore the diagnostic value of serum pyruvate kinase M2(PKM2)and procalcitonin(PCT)in sepsis.Methods One hundred and nineteen sepsis patients(sepsis group)admitted to the Intensive Care Unit(ICU)of Wuhan University People's Hospital from April 2022 to January 2023,and 73 non sepsis patients(non sepsis group)admitted to the ICU during the same period were selected as the study subjects.Detect and compare the serum levels of PKM2 and PCT in two groups of patients within 24 hours of admission,and use Spearman correlation test to analyze the correlation between serum PKM2 and PCT levels in sepsis patients;Using a multivariate logistic regression model to analyze the impact of various indicators on the occurrence of sepsis;Draw a receiver operating characteristic(ROC)curve to evaluate the diagnostic value of serum PKM2,PCT,and their combination in sepsis,and calculate the area under the curve(AUC).Results Compared with the non sepsis group,the serum PKM2 and PCT levels in the sepsis group were significantly increased(Z/P=9.373/<0.001,9.013/<0.001).There is a positive correlation between serum PKM2 and PCT levels in sepsis patients(r=0.322,P<0.001).Multivariate logistic regression analysis showed that elevated levels of serum PKM2 and PCT were independent risk factors for sepsis occurrence[OR(95%CI)=1.182(1.078-1.295),1.582(1.186-2.110)].The ROC curve shows that the AUC of serum PKM2,PCT,and their combination for diagnosing sepsis were 0.903,0.888,and 0.941,respectively,with sensitivity of 0.863,0.918,and 0.932,and specificity of 0.798,0.748,and 0.857,respectively.The combined diagnostic efficacy of the two was higher than that of individual detection(Z/P=2.560/0.011,3.423/<0.001).Conclusion The elevated serum PKM2 level in patients with sepsis is an independent risk factor for sepsis and is positively correlated with PCT.Combined detection of the two has high diagnostic value.
作者
王历
彭适
蔡馨
汤冬玲
张平安
Wang Li;Peng Shi;Cai Xin;Tang Dongling;Zhang Ping'an(Department of Laboratory,Renmin Hospital of Wuhan University,Hubei Province,Wuhan 430060,China)
出处
《疑难病杂志》
CAS
2023年第12期1233-1237,共5页
Chinese Journal of Difficult and Complicated Cases
基金
国家自然科学基金资助项目(81773444)
湖北省卫健委面上科研项目(WJ2023M073)。
