血清CRP、PCT、D-二聚体、NF-κB与严重多发伤患者MODS的二元Logistic回归模型分析

Binary Logistic regression model analysis of serum CRP,PCT,D-dimer,NF-κB and MODS in patients with severe multiple injury

目的 分析血清C-反应蛋白(CRP)、降钙素原(PCT)、D-二聚体(D-D)、单个核细胞核因子-κB(NF-κB)与严重多发伤患者多器官功能障碍综合征(MODS)的二元Logistic回归模型。方法 选取2020年5月—2022年6月在简阳市人民医院诊治的102例严重多发伤患者作为研究对象,根据其入院48 h内是否出现MODS分为MODS组(n=34)与非MODS组(n=68),对比两组入院时血清CRP、PCT、D-D、NF-κB mRNA水平;采用二元Logistic回归分析CRP、PCT、D-D、NF-κB mRNA对严重多发伤患者并发MODS的影响。采用受试者工作特征(ROC)曲线模型分析CRP、PCT、D-D、NF-κB mRNA预测严重多发伤患者并发MODS的曲线下面积(AUC)值、敏感度、特异度。结果 MODS组的CRP、PCT、D-D、NF-κB mRNA均高于非MODS组(t=7.624、7.878、4.218,P<0.05)。Logistic回归分析显示,CRP、PCT、D-D、NF-κB mRNA水平升高是影响严重多发伤患者并发MODS的独立危险因素(P<0.05)。ROC曲线分析显示,血清CRP、PCT、D-D、NF-κB mRNA及4项联合预测严重多发伤患者并发MODS的AUC值分别为(0.796、0.757、0.831、0.697、0.952);且4项联合的AUC值均高于CRP、PCT、D-D、NF-κB mRNA单独检测(Z=2.538、3.485、2.481、4.087,P<0.05)。结论 血清CRP、PCT、D-D、NF-κB mRNA表达随严重多发伤患者并发MODS而升高,监测其水平变化有利于为临床预测MODS提供重要参考。

ObjectiveTo explore the binary Logistic regression model of serum C-reactive protein(CRP),procalcitonin(PCT),D-dimer(D-D),mononuclear nuclear factor-κB(NF-κB) and MODS in patients with severe multiple injury.MethodsA total of 102 patients with severe multiple injuries diagnosed and treated in Jianyang People's Hospital from May 2020 to June 2022 were selected as the study objects.According to whether MODS occurred within 48 hours after admission,they were divided into MODS group(n=34) and non-MODS group(n=68).The mRNA levels of serum CRP,PCT,D-D and NF-κB were compared after admission.Binary Logistic regression model was used to analyze the effects of CRP,PCT,D-D and NF-κB mRNA on MODS in patients with severe multiple injury.ROC curve model was used to analyze the AUC value,sensitivity and specificity of CRP,PCT,D-D and NF-κB mRNA in predicting MODS in patients with severe multiple injury.ResultsThe mRNA levels of CRP,PCT,D-D and NF-κB in MODS group were higher than those in non-MODS group(t=7.624,7.878,4.218,P<0.05).Logistic regression model analysis showed that CRP,PCT,D-D and NF-κB mRNA levels were independent risk factors for MODS in patients with severe multiple injuries(P<0.05).ROC curve analysis showed that the AUC values of serum CRP,PCT,D-D,NF-κB mRNA and the combined prediction of MODS in patients with severe multiple injury were(0.796,0.757,0.831,0.697,0.952,P<0.05).The AUC values of the four combinations were higher than those of CRP,PCT,D-D and NF-κB mRNA alone(Z=2.538,3.485,2.481,4.087,P<0.05).ConclusionSerum CRP,PCT,D-D and NF-κB mRNA expressions increase with MODS in patients with severe multiple injuries,and monitoring the changes of their levels is beneficial to provide an important reference for clinical prediction of MODS.