摘要
目的 分析膈肌超声参数联合血清丙酮酸激酶M2(PKM2)水平检测对脓毒症患者疾病转归的预测价值。方法 2021年04月-2023年11月择取我院107例脓毒症患者为研究对象,根据患者28d生存情况,将患者分为转归良好组(n=35)及转归不良组(n=72)。对比2组临床一般资料及入院时、入院7d时膈肌超声参数[膈肌活动度(DE)、呼吸末膈肌厚度(DTee)、吸气末膈肌厚度(DTei)、膈肌增厚率(DTF)]、血清PKM2水平;分析脓毒症患者发生转归不良的影响因素及对脓毒症患者疾病转归的预测价值。结果 转归不良患者急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、序贯器官衰竭评估(SOFA)评分、外周血白细胞(WBC)、C反应蛋白(CRP)水平均高于转归良好患者(P<0.05);转归良好患者入院时及入院7d时膈肌超声参数DTee、DTei、DTF、DE水平均高于转归不良患者,血清PKM2水平均低于转归不良患者(P<0.05);入院时膈肌超声参数水平为患者发生转归不良的保护因素,血清PKM2、APACHEⅡ评分、SOFA评分、WBC、CRP水平为患者发生转归不良的危险因素(P<0.05);入院时及入院7d时膈肌超声参数联合血清PKM2水平联合预测患者预后不良的AUC为0.913、0.945。结论 隔机超声参数在脓毒症预后不良患者中显著下降,血清PKM2及膈肌超声参数在脓毒症预后不良患者中显著升高,是脓毒症患者预后的影响因素,临床上联合检测血清PKM2及膈肌超声参数可为脓毒症患者预后的预测提供新思路和新方法。
Objective To analyze the predictive value of diaphragm ultrasound parameters combined with serum pyruvate kinase M2(PKM2)level for disease outcomes in sepsis patients.Methods From April 2021 to November 2023,107 patients with sepsis in our hospital were selected as the research objects.According to the 28 day survival of patients,the patients were divided into good outcome group(n=35)and poor outcome group(n=72).The clinical general data of the two groups were compared,as well as diaphragmatic ultrasound parameters[diaphragmatic excursion(DE),diaphragmatic thickness at the end of expiration(DTee),diaphragmaticthicknessat theendofinspiration(DTei),diaphragm thickening fraction(DTF)]and serum PKM2 level at admission and 7 days after admission;the influencing factors of poor outcomes in sepsis patients were analyzed and their predictive value for disease outcomes in sepsis patients was also analyzed.Results The acute physiological function and chronic health evaluationⅡ(APACHEⅡ)score,sequential organ failure assessment(SOFA)score,white blood cell count(WBC)and C-reactive protein(CRP)level in patients with poor outcome were higher than those in patients with good outcome(P<0.05);the levels of DTee,DTei,DTF and DE of diaphragmatic ultrasound parameters in patients with good outcome were higher than those in patients with poor outcome at admission and 7 days after admission,and the level of serum PKM2 was lower than those in patients with poor outcome(P<0.05);the level of diaphragmatic ultrasound parameters at admission was the protective factor for poor outcome,and serum PKM2 level,APACHEⅡscore,SOFA score,the levels of WBC and CRP were the risk factors for poor outcome(P<0.05);the AUC of diaphragm ultrasound parameters combined with serum PKM2 level at admission and 7 days after admission to predict poor prognosis was 0.913 and 0.945.Conclusion Serum PKM2 and diaphragmatic ultrasound parameters are significantly increased in patients with poor prognosis of sepsis,which are the influencing factors of the prognosis of patients with sepsis.The combined detection of serumPKM2 and diaphragmatic ultrasound parameters can provide new ideas and methods for predicting the prognosis of patients with sepsis.
作者
侯琼
崔存英
黄丹青
HOU Qiong;CUI Cunying;HUANG Danqing(Department of Ultrasound,Xinzheng Huaxin People′s Hospital,Xinzheng 451100,Henan,China;Department of Ultrasound,Fuwai Central Cardiovascular Hospital,Zhongmu,Zhengzhou 451450,China)
出处
《航空航天医学杂志》
2025年第2期129-132,共4页
Journal of Aerospace medicine
基金
河南省医学科技攻关联合共建项目(编号:LHGJ20217841)。
关键词
膈肌超声参数
PKM2
脓毒症
疾病转归
Diaphragmatic ultrasound parameters
PKM2
Sepsis
Disease outcome
