糖尿病酮症酸中毒并发感染血清PTX-3及sTREM-1和sCD163联合检测的诊断价值

Value of joint detection of serum PTX-3,sTREM-1 and sCD163 in diagnosis of infection in patients with diabetic ketoacidosis

目的探究糖尿病酮症酸中毒(DKA)患者并发感染血清正五聚蛋白-3(PTX-3)、可溶性髓系细胞触发受体1(sTREM-1)、可溶性CD163分子(sCD163)水平及其诊断价值。方法选取2020年5月-2023年5月内蒙古自治区中医医院收治的119例DKA患者,根据是否并发感染分为感染组52例和非感染组67例,统计DKA患者并发感染类型,检测血清PTX-3、sTREM-1、sCD163、C-反应蛋白(CRP)、降钙素原(PCT)及外周血白细胞计数(WBC)、中性粒细胞计数水平,受试者工作特征(ROC)曲线分析上述指标对DKA患者并发感染的诊断价值。结果119例DKA患者中,并发感染52例(43.70%),其中呼吸系统感染31例占59.62%、消化系统感染16例占30.77%及其他感染5例占9.62%;感染组PTX-3、sTREM-1、sCD163、WBC、中性粒细胞计数、CRP、PCT水平均高于非感染组(P<0.05),联合检测诊断DKA患者并发感染的曲线下面积(AUC)为0.939,敏感度为96.15%,特异度为80.60%。结论DKA患者并发感染发生率较高,感染类型以呼吸系统和消化系统为主;DKA患者并发感染后PTX-3、sTREM-1、sCD163、WBC、中性粒细胞计数、CRP、PCT水平呈高表达,且联合检测可提高DKA患者并发感染的诊断价值。

OBJECTIVE To explore the levels of serum pentraxin-3(PTX-3),soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and soluble CD163 molecule(sCD163)in the patients with diabetic ketoacidosis(DKA)and analyze the diagnostic value.METHODS A total of 119 patients with DKA who were treated in Traditional Chinese Medicine Hospital of Inner Mongolia Autonomous Region from May 2020 to May 2023 were enrolled in the study and were divided into the infection group with 52 cases and the non-infection group with 67 cases according to the status of complication with infection.The types of complicated infection in the DKA patients were statistically analyzed.The levels of serum PTX-3,sTREM-1,sCD163,C-reactive protein(CRP)and procalcitonin(PCT)as well as peripheral blood white blood cell(WBC)and neutrophil counts were detected.The values of the above indexes in diagnosis of infection in the DKA patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Of the 119 DKA patients,52(43.70%)were complicated with infection,31(59.62%)of whom had respiratory system infection,16(30.77%)had digestive system infection,and 5(9.62%)had other infections.The levels of PTX-3,sTREM-1,sCD163,WBC,neutrophils,CRP and PCT of the infection group were significantly higher than those of the non-infection group(P<0.05).The area under curve(AUC)of the joint detection of the indexes was 0.939 in diagnosis of the infection in the DKA patients,with the sensitivity 96.15%,the specificity 80.60%.CONCLUSION The incidence of infection is high among the DKA patients,and the patients with respiratory system infection and digestive system infection are dominant among the patients with the infection.The DKA patients complicated with infection show high expressions of PTX-3,sTREM-1,sCD163,WBC,neutrophils,CRP and PCT.The joint detection of the indexes may raise the diagnostic value of the DKA patients complicated with infection.