动态检测TNF-α、CRP和PCT水平对急诊重症细菌感染患者的预后价值研究

Study on the Prognostic Value of Dynamic Detection of TNF-α,CRP and PCT Levels in Emergency Patients with Severe Bacterial Infection

目的:探究动态检测肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)和降钙素原(PCT)水平对急诊重症细菌感染患者预后的评估价值。方法:选取我院重症医学科2019年5月至2021年12月收治的重症细菌感染患者64例为观察组,另选取同期在我院体检的健康者32例为对照组,比较两组患者入院时TNF-α、CRP和PCT水平的差异性。依据观察组患者治疗后的预后情况将其分为死亡组与存活组,对两组患者TNF-α、CRP和PCT水平进行比较,分析两组上述指标的变化情况,并绘制ROC曲线分析TNF-α、CRP、PCT对急诊重症细菌感染患者预后的诊断效能。结果:与对照组比,观察组患者的TNF-α、CRP、PCT水平均更高(P<0.05)。本研究观察组64例重症细菌感染患者,其中死亡34例(53.13%),存活30例(46.87%)。入院时,死亡组患者的TNF-α、CRP、PCT水平均高于存活组(P<0.05)。经过一段时间入院治疗后,两组患者的TNF-α、CRP、PCT水平较入院时均有不同程度的下降(P<0.05),但死亡组上述指标水平仍旧高于存活组(P<0.05)。TNF-α、CRP、PCT联合检测对重症细菌感染患者预后诊断的AUC为0.789,其敏感度与特异度分别为73.53%和80.00%。结论:联合动态检测TNF-α、CRP、PCT对于重症细菌感染患者预后的评估具有良好的效能。

Objective:To explore the prognostic value of dynamic detection of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and procalcitonin(PCT)levels in emergency patients with severe bacterial infection.Methods:A total of 64 patients with severe bacterial infection who were admitted to the critical care medicine department of our hospital from May 2019 to December 2021 were selected as the observation group,and 32 healthy people who received physical examination in our hospital during the same period were selected as the control group.The levels of TNF-α,CRP and PCT of the patients were compared between the two groups.According to the prognosis after treatment,the patients in the observation group were divided into the death group and the survival group,the levels of TNF-α,CRP and PCT were compared between the two groups of patients,the changes of the above indexes were analyzed,and the ROC curve was drawn to analyze the diagnostic efficacy of TNF-α,CRP and PCT levels on the prognosis of emergency patients with severe bacterial infection.Results:Compared with the control group,the levels of TNF-α,CRP and PCT of patients in the observation group were higher(P<0.05).In this study,there were 64 patients with severe bacterial infection,of which 34 died(53.13%)and 30 survived(46.87%).At admission,the levels of TNF-α,CRP and PCT of patients in the death group were higher than those in the survival group(P<0.05).After a period of treatment,the levels of TNF-α,CRP,and PCT of patients in the two groups decreased to varying degrees compared with those at the time of admission(P<0.05),and the levels of the above indicators in the death group were still higher than those in the survival group(P<0.05).The AUC of the combined detection of TNF-α,CRP and PCT for the prognosis of patients with severe bacterial infection was 0.789,and the sensitivity and specificity were 73.53%and 80.00%respectively.Conclusion:Combined dynamic detection of TNF-α,CRP and PCT has good efficacy in evaluating the prognosis of patients with severe bacterial infection.