摘要
目的:探讨脓毒症患者血清降钙素原(PCT)、D-二聚体(D-D)、肌红蛋白(MYO)水平变化对疾病转归的预测价值。方法:选取2022年4月至2024年4月于洛阳市中心医院(洛阳市紧急救援中心)诊治的208例脓毒症患者进行回顾性分析,依据入院28 d内疾病转归情况分为转归良好组156例、转归不良组52例。比较两组临床资料及治疗前后血清PCT、D-D、MYO水平变化。分析疾病转归不良的影响因素。偏相关分析血清PCT、D-D、MYO水平与疾病转归的相关性。分析血清PCT、D-D、MYO水平对疾病转归的预测价值。结果:转归不良组年龄、APACHE-Ⅱ评分、SOFA评分高于转归良好组(P<0.05);转归不良组治疗后PCT、D-D、MYO水平高于转归良好组(P<0.05);多因素Logistic回归分析显示年龄、SOFA评分及血清PCT、D-D、MYO水平为疾病转归不良的独立危险因素(P<0.05);偏相关分析显示血清PCT、D-D、MYO与疾病转归不良呈正相关(P<0.05);治疗7 d后血清PCT、D-D、MYO联合预测疾病转归的AUC值大于单项指标预测(P<0.05)。结论:脓毒症患者血清PCT、D-D、MYO水平升高与疾病转归不良呈正相关,联合检测其水平对疾病转归具有一定预测价值。
Objective:To explore the predictive value of changes in serum procalcitonin(PCT),D-dimer(D-D)and myoglobin(MYO)levels for disease outcomes in sepsis patients.Methods:A retrospective analysis was conducted on 208 sepsis patients diagnosed and treated at Luoyang Central Hospital(Luoyang Emergency Rescue Center)from April 2022 to April 2024.Based on their disease outcomes within 28 days of admission,the patients were divided into a favorable outcome group(n=156)and an unfavorable outcome group(n=52).Clinical data and changes in serum PCT,D-D and MYO levels before and after treatment were compared between the two groups.Influencing factors for unfavorable disease outcomes were analyzed.Partial correlation analysis was performed to assess the correlation between serum PCT,D-D,MYO levels and disease outcomes.The predictive value of serum PCT,D-D and MYO levels for disease outcomes was also analyzed.Results:The unfavorable outcome group had higher age,APACHE-Ⅱscore and SOFA score compared to the favorable outcome group(P<0.05).After treatment,the unfavorable outcome group exhibited higher serum PCT,D-D and MYO levels than the favorable outcome group(P<0.05).Multivariate logistic regression analysis revealed that age,SOFA score and serum PCT,D-D,MYO levels were independent risk factors for unfavorable disease outcomes(P<0.05).Partial correlation analysis indicated a positive correlation between serum PCT,D-D,MYO levels and unfavorable disease outcomes(P<0.05).The area under the curve(AUC)values for the combined prediction of disease outcomes by serum PCT,D-D and MYO levels 7 days after treatment were greater than those predicted by individual indicators(P<0.05).Conclusion:Elevated serum PCT,D-D and MYO levels in sepsis patients are positively correlated with unfavorable disease outcomes.Combined detection of these indicators has certain predictive value for disease outcomes.
作者
杨帆
岳志城
蔚梅芳
YANG Fan;YUE Zhicheng;WEI Meifang(Emergency Department,Luoyang Central Hospital(Luoyang Emergency Rescue Center),Luoyang 471000,China)
出处
《黑龙江医药科学》
2025年第8期51-54,共4页
Heilongjiang Medicine and Pharmacy
基金
河南省医学科技攻关联合共建项目,编号:LHGJ20221071。
