肝素结合蛋白水平对脓毒症病人预后的影响

Effect of heparin-binding protein level on prognosis of patients with sepsis

目的:探讨血清肝素结合蛋白(HBP)的表达水平对脓毒症病人预后的影响。方法:选取108例脓毒症病人,测定其血清中HBP、降钙素原(PCT)的水平,并进行急性生理与慢性健康(APACHEⅡ)评分以及序贯性器官功能衰竭(SOFA)评分,根据预后将病人分为存活组81例和死亡组27例。比较2组血清HBP和PCT浓度及APACHEⅡ和SOFA评分。分析脓毒症病人HBP和PCT水平及APACHEⅡ和SOFA评分的相关性。logistic回归分析脓毒症病人预后的危险因素。结果:脓毒症死亡组病人HBP和PCT水平及APACHEⅡ和SOFA评分均明显高于存活组(P<0.01)。APHCHEⅡ评分≥15分的脓毒症病人HBP水平明显高于APHCHEⅡ评分<15分者(t=6.13,P<0.01),SOFA评分≥5分的HBP水平明显高于SOFA评分<5分者(t=5.64,P<0.01)。脓毒症病人HBP和PCT水平及APACHEⅡ和SOFA评分呈明显正相关关系(r=0.793、0.735、0.708,P<0.01)。logistic回归分析显示,HBP、PCT是脓毒症病人死亡的独立危险因素(P<0.05)。结论:HBP水平在脓毒症病人中明显升高,是脓毒症病人死亡的独立危险因素,能够一定程度地预测脓毒症病人的不良预后。

Objective:To investigate the effect of serum level of heparin-binding protein(HBP)on the prognosis of patients with sepsis.Methods:The serum levels of HBP and procalcitonin(PCT)were measured,and the acute physiology and chronic health(APACHEⅡ)and sequential organ failure(SOFA)scores were evaluated in 108 patients with sepsis.According to the prognosis,the patients were divided into survival group(81 cases)and death group(27 cases).Serum HBP and PCT levels,APACHEⅡand SOFA scores were compared between the two groups.The correlations of HBP and PCT levels,APACHEⅡand SOFA scores were analyzed.Logistic regression analysis was used to analyze the risk factors of prognosis in patients with sepsis.Results:The HBP and PCT levels,APACHEⅡand SOFA scores in death group were significantly higher than those in survival group of patients with sepsis(P<0.01).The HBP level in patients with APACHEⅡscore≥15 points was significantly higher than that of patients with APACHEⅡscore<15 points(t=6.13,P<0.01),and the HBP level in patients with SOFA score≥5 points was significantly higher than that of patients with SOFA score<5 points(t=5.64,P<0.01).The HBP and PCT levels,APACHEⅡand SOFA scores were significantly positively correlated(r=0.793,0.735,0.708,P<0.01).Logistic regression analysis showed that HBP and PCT were independent risk factors of sepsis(P<0.05).Conclusions:The level of HBP in patients with sepsis is significantly increased,which is an independent risk factor of death and can predict the prognosis of patients with sepsis to some extent.