脓毒症患者血清抵抗素水平与临床预后的相关性

Relationship between serum resistin and the clinical prognosis of patients with sepsis

目的探讨血清抵抗素水平对判断脓毒症患者预后的意义。方法将50例脓毒症患者根据病情轻重分为脓毒症组、严重脓毒症组、脓毒症休克组,另择30例健康者作为对照组,观察各组血清中抵抗素和TNF-α水平。根据预后情况将脓毒症患者分为存活组32例,死亡组18例,分析血清抵抗素水平与患者预后的关系。结果脓毒症各组血清中抵抗素水平均明显高于对照组(均P<0.01),且随病情加重,血清抵抗素水平逐渐升高,各组间比较差异有统计学意义(均P<0.01)。脓毒症患者血清中抵抗素水平与TNF-α水平成正相关(r=0.696,P<0.01)。以脓毒症患者血清抵抗素水平25.55 ng/mL为截断点,判断患者预后不良的特异度达90.6%,阳性预测值为87.5%。结论脓毒症患者血清抵抗素水平明显升高,且比TNF-α更能敏感地反映脓毒症的炎症程度。血清抵抗素水平可作为早期判断脓毒症患者预后的指标。

Objective To study the role of serum resistin in the prognosis of patients with sepsis. Methods Fifty patients with sepsis were divided into three groups： sepsis group,sever sepsis group and septic shock group,with 30 healthy subjects as controls.The levels of serum resistin and TNF-α were measured.Sepsis patients were further assigned into survival group（n=32） and death group（n=18） according to prognosis.Analysis was performed with serum resistin and prognosis record. Results Resistin serum concentration was significantly elevated in septic patients compared with that in healthy controls following a severity-dependent manner（P0.01）.Serum resistin concentration was significantly correlated with TNF-α in septic patients（r=0.696,P0.01）.Using a cutoff of 25.55 ng/mL for resistin in predicting the prognosis of patients with sepsis,the specificity and positive predicted value were 90.6% and 87.5%,respectively. Conclusion Serum resistin concentration is elevated in sepsis.Furthermore,resistin is more sensitive in reflecting inflammation than TNF-α.Therefore,resistin could potentially serve as an early prognostic biomarker for sepsis.