老年尿源性脓毒症的早期预测及病情评估方法

Early prediction of urinary sepsis in elderly patients and assessment of illness condition

目的探讨血清C-反应蛋白(CRP)、血清白蛋白(ALB)、降钙素原(PCT)、肝素结合蛋白(HBP)对老年尿源性脓毒症的早期预测评估价值及与脓毒症严重程度的关系。方法选取于2016年5月-2019年7月于北京大学国际医院进行治疗的老年尿路感染患者96例为研究对象,根据其是否合并尿源性脓毒症分为发生组(n=45)和未发生组(n=51),归纳老年尿路感染患者发生脓毒症的影响因素;受试者工作特征(ROC)曲线分析血清CRP、ALB、PCT、HBP水平在评估老年尿路感染患者发生尿源性脓毒症的价值;对比轻症和重症患者的血清CRP、ALB、PCT、HBP水平。结果老年尿路感染患者的血清CRP、ALB、PCT、HBP是影响其发生脓毒症的影响因素(P<0.05);血清CRP、ALB、PCT、HBP水平对患者行TCRM后发生脓毒症的预测评估均有一定的价值,联合应用价值较高,曲线下面积(AUC)(0.95CI)为:0.828(0.718~0.947);重症患者的血清CRP、ALB、PCT、HBP均高于轻症患者(P<0.05)。结论血清CRP、ALB、PCT、HBP水平可作为预测老年尿路感染患者发生脓毒症的生物学指标,还可用于其病情与预后效果的评估。

OBJECTIVE To investigate the value of serum C-reactive protein(CRP),serum albumin(ALB),procalcitonin(PCT) and heparin-binding protein(HBP) in the early prediction and evaluation of senile urinary sepsis and their relationship with the severity of sepsis.METHODS A total of 96 elderly patients with urinary tract infection who were treated at Peking University International Hospital from May 2016 to Jul.2019 were selected as the research subjects.According to whether they were combined with urinary sepsis,they were divided into the occurrence group(n=45) and the non-occurrence group.Occurrence group(n=51),the influencing factors of sepsis in elderly patients with urinary tract infection were summarized.ROC curve was used to analysis the value of serum CRP,of ALB,PCT and HBP levels in assessing the occurrence of urinary sepsis in elderly patients with urinary tract infection;the serum CRP,ALB,PCT and HBP levels in mild and severe patients were compared.RESULTS Serum CRP,ALB,PCT and HBP of elderly patients with urinary tract infection were the influencing factors for sepsis(P<0.05).Serum CRP,ALB,PCT,and HBP levels were of certain value for the prediction and evaluation of sepsis in patients after TCRM,and the combined application value was relatively higher,with the AUC(0.95CI) of 0.828(0.718-0.947).The serum CRP,ALB,PCT,and HBP levels of patients in the severe group were significantly higher than those of mild paitents(P<0.05).CONCLUSION Serum CRP,ALB,PCT and HBP could be used as biological indicators to predict the occurrence of sepsis in elderly patients with urinary tract infection,and could also be used to evaluate the condition and prognosis of sepsis.