尿源性脓毒症血清α-MSH、IP-10水平及其诊断、预后价值

Serumα-MSH and IP-10 Levels in Urosepsis and TheirDiagnostic and Prognostic Values

目的检测尿源性脓毒症患者血清α-黑色素细胞刺激素(α-MSH)和干扰素诱生蛋白10(IP-10)水平,分析其对患者诊断及预后的预测价值。方法选取本院2020年5月至2022年2月入院治疗的60例尿源性脓毒症患者为研究组,以同期在本院治疗的60例尿路感染患者作为对照组,检测两组血清α-MSH和IP-10水平,对患者进行急性生理与慢性健康评估(APACHEII)评分,采用Pearson相关性分析尿源性脓毒症患者APACHEII评分与血清α-MSH、IP-10水平的关系;根据60例尿源性脓毒症患者治疗28d的生存情况分为生存组(47例)和死亡组(13例),采用Logistic回归分析影响尿源性脓毒症患者预后的因素;通过ROC曲线初步分析α-MSH、IP-10水平和APACHEII评分对患者预后的预测价值。结果研究组血清α-MSH水平显著低于对照组,研究组血清IP-10水平显著高于对照组(P<0.05);α-MSH水平随严重程度的增加而显著降低(P<0.05),IP-10水平随严重程度的增加而显著增加(P<0.05);Pearson分析发现,APACHEII评分与血清α-MSH水平呈负相关(r=-0.313,P<0.05),与血清IP-10水平呈正相关(r=0.374,P<0.05);Logistic回归分析表明,血清α-MSH、IP-10水平和APACHEII评分为尿源性脓毒症患者预后的影响因素(P<0.05);ROC曲线分析得出,α-MSH、IP-10水平和APACHEII评分3者联合应用进行预后评估具有更高的效能。结论尿源性脓毒症患者血清α-MSH呈低水平,IP-10呈高水平,α-MSH、IP-10水平和APACHEII评分联合应用对于预后评估具有较高的效能。

Objective To detect levels of serumα-melanocyte stimulating hormone(α-MSH)and interferon-induced protein 10(IP-10)in patients with urosepsis,and to analyze their predictive values for the diagnosis and prognosis.Methods From May,2020 to February,2022,60 patients with urosepsis who were admitted to our hospital were regarded as the research group,while 60 patients with urinary tract infection in our hospital were included as the control group.Serum levels ofα-MSH and IP-10 in these two groups were detected,and all patients were evaluated with acute physiology and chronic health assessment(APACHE II)score.Pearson correlation method was used to analyze the relationship between APACHE II score and serumα-MSH and IP-10 levels in patients with urosepsis;According to the survival of 60 patients with urosepsis after 28 days of treatment,they were grouped into a survival group(47 cases)and a death group(13 cases).Logistic regression analysis was used to analyze the prognostic factors of patients with urosepsis;The predictive value ofα-MSH,IP-10 levels and APACHE II score on the prognosis of patients was analyzed by ROC curve.Results The serumα-MSH level in the study group was significantly lower than that in the control group,while the serum IP-10 level in the study group was significantly higher than that in the control group(P<0.05);The level ofα-MSH was significantly decreased with increasing severity(P<0.05),while the level of IP-10 was significantly increased with increasing severity(P<0.05);Pearson analysis showed that APACHE II score was negatively correlated with serumα-MSH level(r=-0.313,P<0.05),while positively correlated with serum IP-10 level(r=0.374,P<0.05);Logistic regression analysis showed that serumα-MSH,IP-10 levels and APACHE II score were prognostic factors in patients with urosepsis(P<0.05).ROC curve analysis showed that the combined application ofα-MSH,IP-10 level and APACHE II score for prognostic evaluation had a higher efficacy.Conclusion Serumα-MSH is lowly expressed and IP-10 is highly expressed in patients with urosepsis.The combined application ofα-MSH,IP-10 levels and APACHE II score has a high efficacy in the prognostic evaluation.