慢性肝功能衰竭合并细菌感染患者血清PTX3、HBP水平及其预测患者预后的临床价值

Serum PTX3 and HBP Levels in Patients with Chronic Liver Failure Complicated with Bacterial Infection and their Clinical Value in Predicting Prognosis

【目的】探讨慢性肝功能衰竭(CLF)合并细菌感染患者血清五聚蛋白3(PTX3)、肝素结合蛋白(HBP)水平及其预测患者预后的临床价值。【方法】选取2018年3月至2020年3月西安医学高等专科学校附属医院收治的138例CLF患者,根据是否合并细菌感染将其分为观察组(合并细菌感染,n=58)和对照组(未合并细菌感染,n=80)。采用酶联免疫吸附(ELISA)法检测血清PTX3、HBP水平,分析血清PTX3、HBP表达水平与临床病理特征的关系,比较不同预后情况患者血清PTX3、HBP水平;采用受试者工作特征曲线(ROC曲线)分析血清PTX3、HBP水平对患者预后不良的诊断价值。【结果】观察组患者血清PTX3、HBP水平高于对照组,差异有统计学意义(P<0.05)。不同血清PTX3、HBP水平的患者年龄、性别、糖尿病比较,差异无统计学意义(P>0.05);临床分期、MELD评分及并发症发生情况比较,差异有统计学意义(P<0.05)。死亡组患者血清PTX3、HBP水平均高于生存组,差异有统计学意义(P<0.05)。血清PTX3预测患者预后不良的曲线下面积(AUC)为0.876,敏感度为92.1%,特异性为80.0%;血清HBP预测患者预后不良的AUC为0.893,敏感度为71.1%,特异性为95.0%;二者联合预测的AUC为0.959,敏感度为84.2%,特异性为95.0%。【结论】CLF合并细菌感染患者血清PTX3、HBP呈高表达,PTX3、HBP高表达与患者预后不良有关,是预测患者预后情况的潜在生物学指标。

【Objective】To investigate the levels of serum pentamerin 3(PTX3)and heparin binding protein(HBP)in patients with chronic liver failure(CLF)complicated with bacterial infection and their clinical value in predicting prognosis.【Methods】A total of 138 patients with CLF admitted to Department of General Surgery,Affiliated Hospital of Xi'an Medical College from March 2018 to March 2020 were selected and divided into observation group(with bacterial infection,n=58)and control group(without bacterial infection,n=80)according to whether they were complicated with bacterial infection.The levels of serum PTX3 and HBP were detected by enzyme-linked immunosorbent assay(ELISA),and the relationship between the expression levels of serum PTX3 and HBP and clinicopathological features was analyzed.The levels of serum PTX3 and HBP in patients with different prognosis were compared;ROC curve was used to analyze the diagnostic value of serum PTX3 and HBP levels in patients with poor prognosis.【Results】The levels of serum PTX3 and HBP in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in age,sex and diabetes among patients with different serum PTX3 and HBP levels(P>0.05);There were significant differences in clinical stages,MELD scores and compl ications(P<0.05).The levels of serum PTX3 and HBP in the death group were significantly higher than those in the survival group(P<0.05).The area under curve(AUC)of serum PTX3 in predicting poor prognosis was 0.876,the sensitivity was 92.1%,and the specificity was 80.0%;The AUC of serum HBP in predicting poor prognosis was 0.893,the sensitivity was 71.1%,and the specificity was 95.0%;The AUC predicted by the two methods was 0.959,the sensitivity was 84.2%,and the specificity was 95.0%.【Conclusion】Serum PTX3 and HBP are highly expressed in patients with CLF complicated with bacterial infection.The high expression of PTX3 and HBP is related to the poor prognosis of patients.It is a potential biological index to diagnose the prognosis of patients.