CD64、PCT、SChE对感染性休克患者预后的预测价值

Prognostic value of CD64,PCT and SChE in patients with septic shock

目的探究血清CD64、降钙素原(PCT)和胆碱酯酶(SChE)对感染性休克患者预后的预测价值。方法选取2020年1月至2022年12月皖北煤电集团总医院重症医学二科收治的感染性休克患者118例为研究对象,根据患者28 d预后分为生存组(n=98)与死亡组(n=20)。收集两组患者一般资料,采用全自动生化分析仪检测血清PCT、SChE,流式细胞检测仪检测血清CD64水平,比较两组患者血清CD64、PCT、SChE水平,并绘制ROC曲线评估上述指标单一及联合检测对感染性休克患者预后的预测价值。结果死亡组CD64、PCT水平、APACHEⅡ评分、血清乳酸、白细胞计数、C反应蛋白水平高于生存组,差异均具有统计学意义(t=3.942、7.723、5.246、11.530、6.533、4.426,P<0.05)。生存组血清SChE水平高于死亡组,差异有统计学意义(t=6.288,P<0.05)。多因素Logistic回归分析显示,CD64(β=1.251,OR=3.494)、PCT(β=0.562,OR=1.754)、SChE(β=0.961,OR=2.614)是感染性休克患者预后不良的独立影响因素(P<0.05)。ROC曲线显示,CD64、PCT、SChE三者联合检测时,预测感染性休克患者死亡的AUC为0.960,敏感性、特异性分别为90.0%、94.9%,优于单一检测(P<0.05)。结论感染性休克预后不良患者血清CD64和PCT水平明显升高,SChE水平明显降低,三者联合诊断可为感染性休克患者预后提供重要的参考依据。

Objective To investigate the prognostic value of serum CD64,procalcitonin(PCT)and cholinesterase(SChE)in patients with septic shock.Methods A total of 118 patients with septic shock were selected as the study subjects from January 2020 to December 2022 at the second Department of Critical Care Medicine in North Anhui Coal and Power Group General Hospital.The patients were divided into two groups:the survival group(n=98)and the death group(n=20)based on their 28-day prognosis.General data for both groups of patients were collected,and serum PCT and SChE levels were detected using a fully auto-matic biochemical analyzer.Serum CD64 levels were detected using flow cytometry.The levels of Serum CD64,PCT and SChE were compared between the two groups,and ROC curves were drawn to evaluate the prognostic value of single and combined detection of the above indicators in patients with septic shock.Results The levels of CD64,PCT,APACHEⅡscore,serum lactate,white blood cell count,and C-reactive protein in the death group were significantly higher than those in the survival group(t=3.942,7.723,5.246,11.530,6.533,4.426,P<0.05).The serum SChE level in the survival group was significantly higher than that in the death group(t=6.288,P<0.05).Multivariate logistic regression analysis showed that CD64(b=1.251,OR=3.494),PCT(b=0.562,OR=1.754),and SChE(b=0.961,OR=2.614)were independent influencing factors for poor prognosis in septic shock patients(P<0.05).The ROC curve showed that when CD64,PCT and SChE were combined,the AUC for predicting death in septic shock patients was 0.960,and the sensitivity and specificity were 90.0%and 94.9%,respectively,which was better than that of single detection(P<0.05).Conclusion Serum CD64 and PCT levels were significantly increased,while SChE levels were significantly decreased in patients with septic shock.The combined assessment of CD64 and PCT levels could service as a valuable prognostic indicator for septic shock patients.