摘要
目的探究早期血清降钙素原(PCT)、血钠及脑利钠肽(BNP)水平对脓毒症和脓毒症休克患者预后判断的价值。方法选择2020年12月—2022年12月于淮安市第二人民医院就诊的85例脓毒症和脓毒症休克患者作为观察对象,根据患者28 d后的生存结局将患者分为死亡组(19例)和存活组(66例)。收集患者一般资料,检测入院血清PCT、钠离子、BNP水平;Logistic回归分析影响患者预后的危险因素;Pearson相关性分析各指标与急性生理与慢性健康评分(APACHEⅡ)的相关性;受试者操作特性曲线(ROC)分析各指标对患者预后的预测价值。结果死亡组全身炎症反应综合征(SIRS)评分、APACHEⅡ以及PCT、BNP、Na^(+)水平均显著高于存活组(P<0.05);Logistic回归分析结果显示PCT、APACHEⅡ得分、BNP、Na^(+)水平升高为患者预后不良结局发生的独立危险因素(P<0.05),OR值分别为2.321、2.351、1.692、2.651;患者PCT、BNP和血钠水平与APACHEⅡ评分均呈正相关关系(r分别为0.476、0.653、0.298,均P<0.05);APACHEⅡ、PCT、BNP、Na^(+)和联合检测的ROC曲线下面积分别为0.757、0.609、0.753、0.658、0.919(P<0.05)。结论早期PCT、血钠及BNP水平的升高是预后不良的危险因素,且对脓毒症和脓毒症休克患者预后具有一定的预测价值。
Objective To explore the prognostic value of early serum procalcitonin(PCT),sodium and brain natriuretic peptide(BNP)in patients with sepsis and septic shock.Methods A total of 85 patients with sepsis and septic shock treated in the hospital were enrolled as the observation objects from December 2020 to December 2022.According to 28d survival outcomes,they were divided into death group(19 cases)and survival group(66 cases).The general data of patients were collected,and levels of serum PCT,sodium ion and BNP were detected.The risk factors of prognosis were analyzed by Logistic regression analysis.The correlation between different indexes and scores of acute physiology and chronic health evaluationⅡ(APACHEⅡ)were analyzed by Pearson correlation analysis,and their prognostic value was analyzed by receiver operating characteristic(ROC)curves.Results The scores of systemic inflammatory response syndrome(SIRS)and APACHEⅡ,and levels of PCT,BNP and Na^(+)in death group were significantly higher than those in survival group(P<0.05).The results of Logistic regression analysis showed that increased PCT,APACHEⅡscore,BNP and Na^(+)levels were independent risk factors of adverse outcomes(OR=2.321,2.351,1.692,2.651;P<0.05).The levels of PCT,BNP and serum sodium were positively correlated with APACHEⅡscore(r=0.476,r=0.653,r=0.298,P<0.05).The area under ROC curve(AUC)of APACHEⅡ,PCT,BNP,Na^(+)and combined detection for predicting prognosis were 0.757,0.609,0.753,0.658 and 0.919(P<0.05),respectively.Conclusion The increased PCT,serum sodium and BNP are risk factors of poor prognosis in the early,which all have certain prognostic value for patients with sepsis and septic shock.
作者
王璐璐
黄成
孙明月
张楚杰
燕宪亮
WANG Lulu;HUANG Cheng;SUN Mingyue;ZHANG Chujie;YAN Xianliang(Department of Emergency and Critical Care Medicine,Huai'an Second People's Hospital,Huai'an 223000,Jiangsu,China;Department of Emergency Medicine,The Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu,China)
出处
《西部医学》
2025年第8期1216-1219,1226,共5页
Medical Journal of West China
基金
江苏省卫生健康委员会科研项目(202100102)。
关键词
脓毒症
脓毒症休克
血清降钙素原
血钠
脑利钠肽
Sepsis
Septic shock
Serum procalcitonin
Serum sodium
Brain natriuretic peptide
