创伤性脓毒症患者血清Presepsin水平与疾病严重程度及预后的相关性研究

摘要

目的：探讨创伤性脓毒症患者血清Presepsin水平与疾病严重程度及预后的相关性。方法：选取2012年3月-2015年6月本院急诊科收治的创伤性脓毒症患者146例，根据患者住院期间预后分为存活组（120例）和死亡组（26例），另选取健康志愿者36例作为对照组。所有患者均于入院1 h内抽取肘静脉血，检测并比较血清Presepsin水平，比较存活组和死亡组患者急性生理和慢性健康状况评分Ⅱ（APACHEⅡ）、序贯器官功能衰竭（SOFA）评分，分析血清Presepsin水平与APACHEⅡ、SOFA评分的相关性。结果：脓毒症患者血清Presepsin水平明显高于对照组（P<0.05）；存活组患者血清Presepsin水平、APACHEⅡ评分、SOFA评分均明显低于死亡组患者（P<0.05）；Spearman相关性分析显示，脓毒症患者血清Presepsin水平与APACHEⅡ评分、SOFA评分呈明显正相关（r=0.418，0.366，P<0.05）；ROC曲线显示，血清Presepsin水平预测脓毒症患者住院期间死亡的曲线下面积为0.753（95%CI：0.624~0.866）（P<0.05）。结论：脓毒症患者入急诊科时的血清Presepsin水平与患者病情严重程度及预后相关，可作为指导评估脓毒症患者病情及预后的血清学指标之一。%Objective: To investigate the correlation study of serum levels of presepsin and severity of disease and prognosis on patients with traumatic sepsis.Method: 146 patients with traumatic sepsis from March 2012 to June 2015 in our hospital were selected and divided into survival group (120 cases) and death group (26 cases) according to patients prognosis during hospitalization, another 36 healthy volunteers were selected as control group. All the patients were collected venous blood within 1 h after entering the department of emergency, the serum levels of presepsin was detected and compared, and the acute physiology and chronic health evaluationⅡ (APACHEⅡ), sequential organ failure (SOFA) were compared between survival group and death group, the correlation of serum levels of presepsin and APACHEⅡ, SOFA score was analyzed.Result: The serum levels presepsin of sepsis patients was significantly higher than that of the control group (P<0.05). The serum levels presepsin, APACHEⅡ, SOFA score of the survival group was significantly lower than that of the death group (P<0.05). Spearman correlation analysis showed that the serum level presepsin was positively correlated with APACHEⅡ, SOFA scores (r=0.418,0.366,P<0.05). ROC curve showed that, the AUCROC of the serum levels presepsin predicted the death on patients with traumatic sepsis during hospitalization was 0.753 (95%CI:0.624-0.866) (P<0.05).Conclusion: The serum levels presepsin is correlated with the severity of disease and prognosis on patients with traumatic sepsis, as a serum index to assess the illness and prognosis.