多发伤早期患者血清Mb、CK、IL-6和TNF-α水平对预后的预测意义

Prognostic value of serum Mb,CK,IL -6 and TNF - α levels in patients with early multiple injuries

目的 探讨多发伤患者血清肌红蛋白(Mb)、肌酸激酶(CK)、白细胞介素-6(IL-6)和肿瘤坏死因子(TNF-α)水平对预后的预测价值。方法 选取2018年6月—2021年6月医院收治146例的多发伤患者,将其记为创伤组,另招募52例健康志愿者,将其记为健康组。依据90 d内是否死亡将创伤组分为死亡组和存活组。比较创伤组与健康组的基线血清Mb、CK、IL-6和TNF-α水平;比较死亡组与存活组基线血清Mb、CK、IL-6和TNF-α水平;采用Pearson相关性分析死亡组基线血清Mb、CK与IL-6、TNF-α的关系;绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC),评估对血清Mb、CK、IL-6和TNF-α的预测死亡价值。结果 创伤组的基线血清Mb、CK、IL-6及TNF-α水平均高于健康组(P<0.05);创伤组死亡率为15.07%,死亡组的基线血清Mb、CK、IL-6及TNF-α水平均高于存活组(P<0.05);经Pearson相关性分析可知,死亡组Mb与IL-6、TNF-α均成正相关关系(r值分别为0.912、0.891,P<0.05),CK与IL-6、TNF-α均成正相关关系(r值分别为0.871、0.846,P<0.05);血清Mb、CK、IL-6、TNF-α水平联合预测多发伤患者死亡价值的AUC分别为0.704、0.707、0.591、0.617及0.933。结论 多发伤患者的血清Mb、CK、IL-6和TNF-α均明显增加,死亡风险高,且与血清Mb、CK、IL-6、TNF-α水平均相关,各指标联合预测多发伤患者的死亡风险的价值较高。

Objective This paper aims to investigate the prognostic value of serum myoglobin(Mb),creatine kinase(CK),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels in patients with multiple injuries.Methods A total of 146 patients with multiple injuries admitted to the hospital from June 2018 to June 2021 were selected in the trauma group,and 52 healthy volunteers were recruited as the health group.The trauma group was divided into death group and survival group according to whether death occurred within 90 days.The baselines of serum Mb,CK,IL-6 and TNF-αlevels were compared between the trauma group and the health group.And the baselines of serum Mb,CK,IL-6 and TNF-αlevels were compared between the death group and the survival group.Pearson correlation was used to analyze the relationship between the baselines of serum Mb,CK and IL-6 and TNF-αlevels in the death group.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated to evaluate the predictive value of serum Mb,CK,IL-6 and TNF-αlevels for death.Results The baselines of serum Mb,CK,IL-6 and TNF-αlevels in the trauma group were significantly higher than those in the health group(P<0.05).The mortality of trauma group was 15.07%.The baselines of the serum Mb,CK,IL-6 and TNF-αlevels in the death group were higher than those in the survival group(P<0.05).Pearson correlation analysis showed that in the death group,Mb was positively correlated with IL-6 and TNF-α(r=0.912,r=0.891,P<0.05);CK was positively correlated with IL-6 and TNF-α(r=0.871,0.846,P<0.05).The prognostic AUC values of serum Mb,CK,IL-6 and TNF-αlevels in patients with multiple injuries on death were 0.704,0.707,0.591,0.617 and 0.933,respectively.Conclusion The serum levels of MB,CK,IL-6 and TNF-αin patients with multiple trauma are significantly increase,and the risk of death is high,which are correlated with the serum levels of Mb,CK,IL-6 and TNF-α,and the value of combined prediction of all indicators in the risk of death of patients with multiple trauma is high.