血清降钙素原D-二聚体 视黄醇结合蛋白与脓毒血症患者病情程度及预后关系研究

Study on the relationship between serum serum procalcitonin,D-dimer,retinol-binding protein and the degree and prognosis of septicemia patients

目的分析探讨血清降钙素原(PCT)、D-二聚体(D-D)、视黄醇结合蛋白(RBP)与脓毒血症患者病情程度、预后的关系。方法选取2022年1月至2024年1月本院收治的110例脓毒血症患者为对象纳入观察组,另选同期在本院进行体检的健康者50名为对照组。采集患者及健康体检者的血液样本,检测对比血清PCT、D-D、RBP水平,将观察组分为脓毒症组和脓毒症休克组,对比2组PCT、D-D、RBP水平,序贯器官衰竭评估评分(SOFA)、急性生理和慢性健康评估Ⅱ评分(APACHEⅡ)。根据患者的预后情况分为存活组、死亡组,比较不同预后患者的血清学指标的差异性,并分析血清学指标与评分间相关性。结果观察组患者的血清PCT、D-D、RBP分别为(2.17±0.46)μg/L、(456±51)μg/L、(78.1±8.3)mg/L水平均高于对照组分别为(0.39±0.11)μg/L、(217±31)μg/L、(43.4±5.8)mg/L(P<0.05)。脓毒症休克组患者的血清PCT、D-D、RBP及SOFA、APACHEⅡ评分分别为(2.49±0.49)μg/L、(504±52)μg/L、(83.1±8.2)mg/L、(12.8±4.9)分、(28.1±7.0)分均高于脓毒症组(1.93±0.42)μg/L、(420±48)μg/L、(74.4±8.0)mg/L、(9.2±2.9)分、(23.0±5.0)分(P<0.05)。预后死亡组患者的血清PCT、DD、RBP及SOFA、APACHEⅡ评分分别(2.52±0.53)μg/L、(511±55)μg/L、(87.2±9.0)mg/L、(13.7±4.2)分、(30.4±5.2)分均高于预后存活组分别为(1.89±0.41)μg/L、(408±48)μg/L、(72.0±8.0)mg/L、(9.0±2.8)分、(21.2±4.9)分(P<0.05)。经Pearson检验分析,脓毒血症患者的SOFA、APACHEⅡ评分与血清PCT、D-D、RBP水平呈正相关性。结论血清PCT、D-D、RBP在脓毒血症患者中呈现高表达,其水平变化与患者的病情程度和预后效果密切相关。

Objective To analyze and investigate the relationship between serum procalcitonin(PCT),D-dimer(DD),retinol-binding protein(RBP)and the degree of condition and prognosis of patients with sepsis.Methods A total of 110 septicemia patients admitted to our hospital from January 2022 to January 2024 were selected in the observation group,and another 50 healthy subjects who underwent physical examination in our hospital during the same period were selected as the control group.Blood samples were collected,and serum PCT,D-D and RBP levels were tested and compared.The observation group was divided into sepsis group and septic shock group,comparing PCT,D-D and RBP levels,Sequential Organ Failure Assessment Score(SOFA),Acute Physiology and Chronic Health EvaluationⅡScore(APACHEⅡ)of the two groups.According to the prognosis of the patients,they were divided into the survival group and the death group,and the differences in the serological indexes of the patients with different prognoses were compared,and the correlation between the serological indexes and the scores was analyzed.Results The serum PCT,DD,and RBP levels of the observation group were(2.17±0.46)μg/L,(456±51)μg/L,and(78.1±8.3)mg/L,respectively,which were higher than those of the control group,which were(0.39±0.11)μg/L,(217±31)μg/L,and(43.4±5.8)mg/L,respectively(P<0.05).The serum PCT,DD,RBP,SOFA,and APACHEⅡscores of the septic shock group were(2.49±0.49)μg/L,(504±52)μg/L,(83.1±8.2)mg/L,(12.8±4.9)points,and(28.1±7.0)points,respectively,which were higher than those of the septic group(1.93±0.42)μg/L,(420±48)μg/L,(74.4±8.0)mg/L,(9.2±2.9)points,and(23.0±5.0)points(P<0.05).The serum PCT,DD,RBP,SOFA,and APACHEⅡscores of the prognostic death group were(2.52±0.53)μg/L,(511±55)μg/L,(87.2±9.0)mg/L,(13.7±4.2)points,and(30.4±5.2)points,respectively,higher than those of the prognostic survival group,which were(1.89±0.41)μg/L,(408±48)μg/L,(72.0±7.9)mg/L,(9.0±2.8)points,and(21.2±4.9)points(P<0.05).Conclusion Serum PCT,DD and RBP showed high expression in sepsis patients,and the changes of their levels were closely related to the degree of the patients′condition and prognostic effects.