外周血高迁移率族蛋白B1、血小板活化因子水平预测脓毒症休克患者近期预后的价值

Value of peripheral blood HMGB1 and platelet activating factor levels in predicting the short-term prognosis of patients with septic shock

目的探讨外周血高迁移率族蛋白B1(HMGB1)、血小板活化因子(PAF)水平预测脓毒症休克患者近期预后的价值。方法选取2018年5月—2021年5月大连市中心医院收治的脓毒症休克患者85例作为研究对象,收集所有患者临床资料,包括治疗前HMGB1、PAF,患者治疗后随访28 d并统计其生存情况。分析影响脓毒症休克患者近期预后的因素,分析HMGB1、PAF水平预测脓毒症休克患者近期预后的价值。结果85例脓毒症休克患者随访期间死亡28例,57例生存。逐步多因素Logistic回归分析结果显示,急性生理学和慢性健康状况评估Ⅱ(APACHEⅡ)评分[OR=5.441(95%CI:2.392,12.378)]、氧合指数[OR=4.577(95%CI:2.012,10.411)]、HMGB1[OR=4.341(95%CI:1.908,9.874)]、PAF[OR=4.491(95%CI:1.974,10.215)]是影响脓毒症休克患者近期预后的独立因素(P<0.05)。ROC曲线结果显示,HMGB1、PAF及两者联合预测脓毒症休克患者近期预后的敏感性分别为71.43%、75.00%和71.43%,特异性分别为70.18%、73.68%和89.47%,AUC分别为0.752、0.764和0.879。结论脓毒症休克患者预后不良风险较高,HMGB1、PAF与脓毒症休克患者近期预后有关,两者联合预测脓毒症休克患者预后效能较好。

Objective To explore the value of peripheral blood high mobility group protein B1(HMGB1)and platelet activating factor(PAF)levels in predicting the short-term prognosis of patients with septic shock.Methods A total of 85 patients with septic shock admitted to the hospital from May 2018 to May 2021 were selected.The general clinical data of all patients were collected and the levels of HMGB1 and PAF before the treatment were detected.After the treatment,the patients were followed up for 28 days and their survival status was recorded.Factors affecting the short-term prognosis of patients with septic shock were determined.The value of HMGB1 and PAF levels in predicting the short-term prognosis of patients with septic shock was analyzed.Results During the follow-up,28 of 85 patients with septic shock died,and the rest 57 survived.The multivariable Logistic regression analysis showed that the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score[OR=5.441(95%CI:2.392,12.378)],oxygenation index[OR=4.577(95%CI:2.012,10.411)],HMGB1 level[OR=4.341(95%CI:1.908,9.874)],and PAF level[OR=4.491(95%CI:1.974,10.215)]were independent factors affecting the short-term prognosis of patients with septic shock(P<0.05).The ROC curve analysis revealed that the sensitivities of HMGB1,PAF and the combination of the two for predicting the short-term prognosis of patients with septic shock were 71.43%,75.00% and 71.43%,the specificities were 70.18%,73.68% and 89.47%,and the areas under the ROC curves(AUCs)were 0.752,0.764 and 0.879,respectively.Conclusions Patients with septic shock have a higher risk of poor prognosis.HMGB1 and PAF levels are related to the short-term prognosis of patients with septic shock.The combination of the two shows great efficacy in predicting the prognosis of patients with septic shock.