MR-proADM、HBP及PCT在脓毒症患者血清中的表达及意义

Expression and significance of MR-proADM,HBP and PCT in serum of patients with sepsis

目的研究肾上腺髓质前体中段肽(MR-proADM)、肝素结合蛋白(HBP)和降钙素原(PCT)联合检测在脓毒症早期诊断中的临床价值。方法选取2015年9月至2017年6月该院重症监护室收治的脓毒症患者54例,根据疾病严重程度分为脓毒症组(25例)、严重脓毒症组(17例)和脓毒性休克组(12例),选取同期有局部感染的非脓毒症患者30例作为对照组。检测各组患者血清MR-proADM、HBP及PCT表达水平,运用受试者工作特征曲线分析各指标联合检测诊断脓毒症的效能并探讨各指标的相关性。结果 4组研究对象血清MR-proADM、HBP和PCT表达水平比较,差异均有统计学意义(P<0.05),且表达水平由高至低依次为脓毒性休克组、严重脓毒症组、脓毒症组、对照组。MR-proADM、HBP和PCT联合检测诊断脓毒症的效能高于单独检测MR-proADM、HBP和PCT。MR-proADM与HBP、MR-proADM与PCT、HBP与PCT均呈正相关(r=0.306、0.676、0.443,P=0.000)。结论血清MR-proADM、HBP和PCT表达水平与脓毒症严重程度相关,三者联合检测可有助于脓毒症的早期诊断。

Objective To study the clinical value of combined detection of adrenomedullary proADM（MRproADM）,heparin binding protein（HBP）and procalcitonin（PCT）in early diagnosis of sepsis.Methods 54 patients with sepsis admitted to the intensive care unit of the hospital from September 2015 to June 2017 were divided into sepsis group（25 cases）,severe sepsis group（17 cases）and septic shock group（12 cases）according to the severity of the disease.30 non-sepsis patients with local infection in the same period were selected as the control group.The serum levels of MR-proADM,HBP and PCT in each group were detected.The efficacy of each index in the diagnosis of sepsis was analyzed by using the working characteristic curve of the subjects and the correlation of each index was discussed.Results The expression levels of serum MR-proADM,HBP and P CT in the four groups were significantly different（P0.05）,and the order of expression levels from high to low was septic shock group,severe sepsis group,sepsis group and control group.The combined detection of MR-proADM,HBP and PCT was more effective than that of MR-proADM,HBP and PCT alone in the diagnosis of sepsis.MR-proADM was positively correlated with HBP and PCT,HBP was positively correlated with PCT（r=0.306,0.676,0.443,P=0.000）.Conclusion The expression levels of serum MR-proADM,HBP and PCT were correlated with the severity of sepsis,and the combined detection of them can be helpful for the early diagnosis of sepsis.