摘要
目的探讨烧伤患者早期血清肝素结合蛋白(HBP)与炎症因子水平的相关性,并评估其对不同烧伤程度患者临床预后的预测价值。方法回顾性纳入2024年1月至2024年12月攀钢集团总医院收治的96例烧伤患者,依据烧伤程度分为轻度、严重和危重烧伤组,动态监测血清HBP及炎症因子(IL-6、TNF-α、PCT、hs-CRP)在入组12 h、24 h和48 h的变化。根据患者28 d内生存状态分为生存组和死亡组,分析血清HBP与炎症因子的相关性,并评估其预测效能。结果危重烧伤组的APACHE II评分、SOFA评分及死亡率高于其他组(P<0.05)。危重烧伤组在HBP、IL-6、TNF-α水平方面显著高于其他组(P<0.05)。死亡组的HBP、IL-6、APACHE II和SOFA评分显著高于生存组(P<0.01)。HBP与IL-6呈强正相关(P<0.01)。多因素回归分析显示,HBP和IL-6为烧伤患者死亡的独立危险因素(OR分别为5.242和3.124)。ROC曲线显示,HBP联合IL-6预测28 d内死亡的AUC为0.853优于单一检测(P<0.05)。结论血清HBP与IL-6显著相关,二者的早期升高与烧伤严重程度及预后呈正相关,可作为死亡风险的预警指标,二者联合检测能提高预后评估准确性。
Objective To explore the correlation and diagnostic performance of serum NT-proBNP and HBDH levels for cardiac dysfunction in severe burn patients with sepsis.Methods 130 cases of severe burn patients admitted from March 2023 to March 2025 were conducted by retrospective study.The patients were divided into three groups:sepsis with heart failure(n=22),sepsis(n=33),and burns only(n=75).Serum levels of PCT,hs-CRP,NT-proBNP,and HBDH were measured at 24-,48-,and 72-hours post-admission.LVEF,LAVI,and SOFA scores were recorded.Pearson correlation analysis and ROC curves were used to assess diagnostic efficacy.Results At all time points,the levels of HBDH and NT-proBNP were higher in the sepsis with heart failure group compared to the sepsis group and burns only group.HBDH peaked at 24 hours post-admission,while NT-proBNP peaked at 48 hours.Hs-CRP and PCT levels increased over time,with the sepsis and sepsis with heart failure groups showing higher levels than the burns only group(P<0.05),However,there was no statistically significant difference between the sepsis group and the sepsis with cardiac dysfunction group(P>0.05).LVEF showed the pattern:burn alone group>sepsis group>sepsis with cardiac dysfunction group,with statistically significant differences(P<0.05).LAVI and SOFA scores showed the pattern:burn alone group<sepsis group<sepsis with cardiac dysfunction group.Correlation analysis revealed that HBDH at 24 hours post-admission and NT-proBNP at 48 hours post-admission was strongly negatively correlated with LVEF(|r|≥-0.7,P<0.05)and moderately negatively correlated with LAVI(P<0.05).ROC analysis revealed that the combination of HBDH at 24 hours and NT-proBNP at 48 hours had the highest AUC for diagnosing sepsis with heart failure(0.852),outperforming single markers(P<0.05).Conclusion Dynamic monitoring of serum NT-proBNP and HBDH levels in severe burn patients helps in the early detection of sepsis-related heart failure.Combined testing enhances diagnostic efficacy and establishes a basis for early clinical intervention.
作者
陈宝国
孙宏建
刘少博
王志中
包树明
CHEN Baoguo;SUN Hongjian;LIU Shaobo;WANG Zhizhong;BAO Shuming(Department of Burn,Pangang Group General Hospital,Panzhihua,Sichuan,China,617023)
出处
《分子诊断与治疗杂志》
2026年第1期104-107,共4页
Journal of Molecular Diagnostics and Therapy
基金
攀枝花市指导性科技计划项目(2023ZD-S-33160)。
