血清D-dimer、SDC-1、sTLT-1水平对多发伤合并多器官功能障碍综合征患者预后的预测价值

Prognostic value of serum D-dimer,SDC-1 and sTLT-1 levels in patients with multiple injuries complicated with multiple organ dysfunction syndrome

目的探讨血清D-二聚体(D-dimer)、多配体蛋白聚糖-1(SDC-1)和可溶性髓样细胞触发受体样转录因子-1(sTLT-1)表达水平对多发伤合并多器官功能障碍综合征(MODS)患者预后的预测价值。方法选取2022年2月至2023年2月石家庄长城中西医结合医院收治的165例急诊多发伤患者,根据是否合并MODS将其分为MODS组(66例)和无MODS组(99例),根据入院第28天MODS组患者的生存结局将多发伤合并MODS患者为死亡组(32例)和存活组(34例)。比较各组血清D-dimer、SDC-1和sTLT-1表达水平。采用多因素Logistic回归分析影响多发伤合并MODS患者预后不良的影响因素。绘制受试者工作特征(ROC)曲线分析D-dimer、SDC-1、sTLT-1对多发伤合并MODS患者预后的预测价值。结果多发伤合并MODS患者血清D-dimer、SDC-1及sTLT-1水平明显高于无MODS组,差异有统计学意义(P<0.05);多发伤合并MODS患者中死亡组血清D-dimer、SDC-1和sTLT-1水平均明显高于存活组,差异有统计学意义(P<0.05);血清D-dimer、SDC-1及sTLT-1水平升高均是多发伤合并MODS患者预后不良的危险因素(P<0.05);D-dimer、SDC-1和sTLT-1联合预测多发伤合并MODS患者预后的效能优于D-dimer、SDC-1和sTLT-1各自单独预测(P<0.05)。结论血清D-dimer、SDC-1及sTLT-1水平在多发伤合并MODS患者中明显升高,三者联合检测可评估多发伤合并MODS患者的预后。

Objective To investigate the prognostic value of serum D-dimer,syndecan-1(SDC-1),and soluble myeloid cell triggered receptor like transcription factor-1(sTLT-1)expression levels of patients with multiple injuries complicated with multiple organ dysfunction syndrome(MODS).Methods From February 2022 to February 2023,165 emergency patients with multiple injuries admitted to Shijiazhuang Great Wall Hospital of Integrated Chinese and Western Medicine were selected and divided into MODS group(66 cases)and non-MODS group(99 cases)according to whether they complicated with MODS.The patients with multiple injuries combined with MODS were divided into the death group(32 cases)and the survival group(34 cases)according to the survival outcome of the MODS group on the 28th day of admission.The serum D-dimer,SDC-1,and sTLT-1 levels of all the groups were compared.Multivariate Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with multiple injuries complicated with MODS.Receiver operating characteristic(ROC)curve was plotted to analyze the prognostic value of D-dimer,SDC-1,sTLT-1,and combined detection for prognosis in patients with multiple injuries combined with MODS.Results The serum levels of D-dimer,SDC-1 and sTLT-1 in patients with multiple injuries combined with MODS were significantly higher than those in non-MODS group,with statistical significance(P<0.05).The levels of D-dimer,SDC-1 and sTLT-1 in the death group were significantly higher than those in the survival group,with statistical significance(P<0.05).The increase of serum D-dimer,SDC-1 and sTLT-1 levels were the risk factors for poor prognosis in patients with multiple injuries combined with MODS(P<0.05).D-dimer,SDC-1 and sTLT-1 combined predicted the prognosis of patients with multiple injuries and MODS better than D-dimer,SDC-1 and sTLT-1 alone(P<0.05).Conclusion Serum D-dimer,SDC-1 and sTLT-1 levels are significantly increased in patients with multiple injuries complicated with MODS.The combined detection of the three can evaluate the prognosis of patients with multiple injuries complicated with MODS.