摘要
目的 探讨肝素结合蛋白联合血清降钙素原(PCT)、C反应蛋白(CRP)检测对急诊老年脓毒症患者病情和预后的评估价值。方法 回顾性选取2022年6月—2024年2月在我院确诊的82例急诊老年脓毒症患者,按照脓毒症患者病情严重程度分为脓毒症组(n=52)和脓毒症休克组(n=30)。比较患者入院24 h内血清肝素结合蛋白、PCT和CRP水平,对各个指标进行相关性分析;统计脓毒症患者入院24 h内急性生理与慢性健康状况评估(APACHEⅡ)评分和28 d预后情况。根据患者入院28 d内预后情况为71例存活和11例死亡,分别纳入存活组和死亡组。分析血清肝素结合蛋白、PCT和CRP水平和APACHEⅡ评分的相关性,并采用受试者工作特征(ROC)曲线评估上述指标对患者预后的预测价值。结果 脓毒症休克组患者的肝素结合蛋白、PCT和CRP水平均较脓毒症组高,差异均有统计学意义(P<0.05)。老年脓毒症患者血清肝素结合蛋白、PCT和CRP水平均与疾病严重程度呈正相关(P<0.05)。存活组患者的血清肝素结合蛋白、PCT、CRP水平和APACHEⅡ评分均较死亡组低,差异有统计学意义(P<0.05)。老年脓毒症患者血清肝素结合蛋白、PCT和CRP水平均和APACHEⅡ评分呈正相关(P<0.05)。ROC曲线分析结果显示,血清肝素结合蛋白、PCT、CRP水平及其联合检测的ROC下曲线面积(AUC)为0.768、0.764、0.748和0.818,联合检测敏感度为81.82%,特异度为88.73%(P<0.05)。结论 老年脓毒症患者血清肝素结合蛋白、PCT和CRP水平均和疾病严重程度呈正相关,且上述指标联合检测在急诊老年脓毒症患者预后评估中具有较高的预测效能。
Objective To explore the evaluation value of heparin-binding protein combined with serum procalcitonin(PCT)and C-reactive protein(CRP)in disease severity and prognosis of elderly emergency patients with sepsis.Methods A total of 82 elderly emergency patients with sepsis confirmed in the hospital were retrospectively enrolled as study group from June 2022 to February 2024.According to disease severity,they were divided into sepsis group(n=52)and septic shock group(n=30),levels of serum heparin-binding protein,PCT and CRP were compared between the two groups within 24h after admission.The correlation of the three indexes was analyzed.The scores of acute physiological and chronic health evaluationⅡ(APACHEⅡ)within 24h after admission and 28d prognosis were statistically analyzed.The correlation between serum heparin-binding protein,PCT,CRP levels and APACHEⅡscore was analyzed,and predictive value of the above indexes for prognosis was evaluated by receiver operating characteristics(ROC)curves.Results The levels of heparin-binding protein,PCT and CRP in septic shock group were higher than those in sepsis group(P<0.05).The levels of serum heparin-binding protein,PCT and CRP were positively correlated with disease severity in elderly patients with sepsis(P<0.05).Within 28d after admission,there were 71 survival cases(survival group)and 11 death cases(death group),respectively.The levels of serum heparin-binding protein,PCT and CRP,and APACHEⅡscore in survival group were lower than those in death group(P<0.05).The levels of serum heparin-binding protein,PCT and CRP were positively correlated with APACHEⅡscore in elderly patients with sepsis(P<0.05).ROC curves analysis showed that area under ROC curve(AUC)values of serum heparin-binding protein,PCT,CRP and combined detection for predicting prognosis were 0.768,0.764,0.748 and 0.818,respectively.The sensitivity and specificity of combined detection were 81.82%and 88.73%,showing high predictive efficiency(P<0.05).Conclusion The levels of serum heparin-binding protein,PCT and CRP are positively correlated with disease severity in elderly patients with sepsis,and combined detection of the three indexes has high predictive efficiency for prognosis of elderly emergency patients with sepsis.
作者
韩虹宇
褚佳琪
赵永秀
陈刚
HAN Hongyu;CHU Jiaqi;ZHAO Yongxiu;CHEN Gang(Department of Laboratory Medicine,The First Medical Center,PLA General Hospital,Beijing 100039,China)
出处
《西部医学》
2025年第12期1859-1862,1867,共5页
Medical Journal of West China
关键词
老年
脓毒症
肝素结合蛋白
降钙素原
C反应蛋白
预后
Elderly
Sepsis
Heparin-binding protein
Procalcitonin
C-reactive protein
Prognosis
