血浆8-异前列腺素F2α水平对感染性休克短期预后判断的临床价值

The Clinical Values of the Dynamic Variety of Plasma 8-iso-PGF2α on the Short-term Prognosisof Patients with septic shock

目的分析血浆8-异前列腺素F2α(8-iso-PGF2α)水平动态变化对评估感染性休克患者病情及短期预后的临床价值。方法选择我院就诊的78例感染性休克患者作为研究对象,均予以积极临床治疗,于治疗前、治疗第1、3、7天分别检测每位患者血浆8-iso-PGF2α、血清超敏C反应蛋白(hs-CRP)、白介素(IL)-1、肿瘤坏死因子(TFN-α)水平,同时评估感染相关器官功能衰竭评分(SOFA)以及急性生理和慢性健康状况评分(APACHEⅡ)。分析每个时间点血浆8-isoPGF2α水平与SOFA及APACHEⅡ的相关性。随访半年,根据患者预后结局分为生存组和死亡组。应用多元Logistic回归分析随访半年感染性休克患者预后的危险因素;应用ROC曲线评估血浆8-iso-PGF2α对感染性休克患者随访半年预后评估特异性和灵敏度。结果随着治疗时间增加,两组患者血浆8-iso-PCF2α及hs-CRP、IL-1、TFN-α水平进行性下降(P<0.05);而同时间点生存组患者的血浆8-iso-PGF2α水平均显著小于死亡组(P<0.05),但两组血清hs-CRP、IL-1及TFN-α差异无统计学意义(P>0.05)。各时间点的血浆8-iso-PGF2α水平与SOFA及APACHEⅡ均为正相关(P <0.05)。多元Logistic回归分析,血浆8-iso-PGF2α水平是随访半年感染性休克患者预后危险因素(P<0.05)。ROC曲线评估血浆8-iso-PGF2α水平对随访半年感染性休克患者预后不良有显著预测价值(P <0.05),且判定血浆8-iso-PGF2α水平切点为28. 7ng/mL时对预测随访半年感染性休克患者预后不良有85. 6%的灵敏度和78. 8%的特异性。结论血浆8-iso-PGF2α随治疗进行而降低,且对感染性休克患者预后判断有较高价值。

Objective To analyze the clinical values of the dynamic variety of plasma 8-iso prostaglanlin F2 alpha(8-iso-PGF2α)on the short-term prognosis of patients with septic shock.Methods 78 patients diagnosed with septic shock in our hospital were collected for the study and received the regular clinical therapy.The plasma levels of 8-iso-PGF2αand the serum levels of hypersensitive C-reactive protein(hs-CRP),interleukin(IL)-1,tumor necrosis factor(TFN-α)were detected at time points of pre-therapy,1st day,3rd day and 7th day post-therapy,respectively.And the degrees of sepsis-related organ failure assessment(SOFA)and APACHEⅡwere also analyzed at above time points,respectively.The correlation of the plasma levels of 8-iso-PGF2αand the degrees of SOFA and APACHEⅡwere then analyzed.Followed-up for half a year,all patients were divided into two groups according to the prognosis,which were the survival group and death group.The risk factors of the half-year prognosis were analyzed by multivariate logistic regression analysis.The clinical value of the plasma levels of 8-iso-PGF2αto the half-year prognosis was evaluated by the receiver operating characteristic(ROC)curve.Results As the treatment time was going forward,the plasma levels of 8-iso-PGF2α,hs-CRP,IL-1 and TFN-αin two group were descending(P<0.05),and the plasma levels of 8-iso-PGF2αin the survival group was lower than that of the death group at the same time-point(P<0.05),but the serum levels of 8-iso-PGF2α,hs-CRP,IL-1 and TFN-αhad no difference between two groups(P>0.05).There was a positive correlation between the plasma levels of 8-iso-PGF2αand the degrees of SOFA and APACHEⅡat the same time point(P<0.05).The plasma levels of 8-iso-PGF2αwere the risk factor of the half-year prognosis to the patients with septic shock by multivariate logistic regression analysis(P<0.05).The ROC curve identified the cutoff levels of plasma 8-iso-PGF2α(2.8ng/mL)to the half-year prognosis to the patients with septic shock,with the sensitivity of 86.9%and specificity of 89.5%.Conclusion The dynamic variety of plasma levels of 8-iso-PGF2αis descending as the treatment time going forward,and has the better clinical value of prognosis.