外周血NEU/ALB、Presepsin、sRAGE与脓毒症患者病情严重程度相关性及对预后的预测价值

Correlation between peripheral blood NEU/ALB,Presepsin and sRAGE and severity of sepsis patients and their predictive value for prognosis

目的探讨外周血中性粒细胞/白蛋白(NEU/ALB)、可溶性白细胞分化抗原14亚型(Presepsin)、可溶性晚期糖基化终末产物受体(sRAGE)与脓毒症患者病情严重程度相关性,并分析其对预后的预测价值。方法选取2019年5月至2022年8月郑州大学第一附属医院收治的106例脓毒症患者为研究对象,依据28 d内生存情况分为预后良好组(n=68)、预后不良组(n=38)。比较两组基线资料、生化指标、序贯器官衰竭评分(SOFA)、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)。分析不同组别(入院时、治疗7 d后)、不同病情严重程度患者外周血NEU/ALB、Presepsin、sRAGE水平。分析外周血各指标与生化指标、SOFA、APACHEⅡ评分、病情严重程度相关性。采用受试者工作特征曲线(ROC)分析外周血各指标对预后的预测价值。结果治疗7 d后两组NEU/ALB、Presepsin、sRAGE水平低于入院时,且预后不良组高于预后良好组(P<0.05);NEU/ALB、Presepsin、sRAGE与SOFA评分、APACHEⅡ评分、生化指标、病情严重程度呈正相关(P<0.05);治疗7 d后外周血各指标联合预测预后的曲线下与坐标轴围成的面积(Area under curve,AUC)大于单项预测(P<0.05)。结论外周血NEU/ALB、Presepsin、sRAGE可反映脓毒症患者病情严重程度,联合检测其水平对预后具有一定预测价值。

Objective To investigate the correlation between peripheral blood neutrophil/albumin(NEU/ALB),soluble leukocyte differentiation antigen subtype 14(Presepsin),soluble receptor for advanced glycosylation end products(sRAGE)and severity of sepsis patients,and to analyze their predictive value for prognosis.Methods One hundred and six patients with sepsis admitted to our hospital from May 2019 to August 2022 were selected for the study and were divided into good prognosis group(n=68)and poor prognosis group(n=38)based on survival within 28 d.Baseline data,biochemical indicators,sequential organ failure score(SOFA),and acute physiology and chronic health status scoring system II(APACHE II)were compared between the two groups.Peripheral blood NEU/ALB,Presepsin,and sRAGE levels were analyzed in different groups(at admission,after 7 d of treatment)and in patients with different severity of disease.The correlation of peripheral blood indicators with biochemical indicators,SOFA,APACHE II score,and severity of disease were analyzed.The predictive value of each index of peripheral blood on prognosis was analyzed using subject operating characteristic curve(ROC).Results NEU/ALB,Presepsin,and sRAGE levels were lower in both groups after 7 d of treatment than at admission,and the poor prognosis group was higher than the good prognosis group(P<0.05);NEU/ALB,Presepsin,and sRAGE were positively correlated with SOFA score,APACHE II score,biochemical indexes,and severity of disease(P<0.05);After 7 d of treatment the area under curve(AUC)of peripheral blood indicators to predict prognosis after 7 d of treatment was greater than that of the individual predictions(P<0.05).Conclusion Peripheral blood NEU/ALB,Presepsin,and sRAGE can reflect the severity of sepsis patients,and their combined levels have some predictive value for prognosis.