| 周欣乐,康 焰,田春霖,施 红,章阿元.脓毒症患者血清FGF-21、MR-proADM、炎性因子与预后的关系分析[J].,2020,(6):1146-1149 |
| 脓毒症患者血清FGF-21、MR-proADM、炎性因子与预后的关系分析 |
| The Relationship between Serum FGF-21, MR-proADM, Inflammatory Factors and Prognosis in Patients with Sepsis |
| 投稿时间：2019-10-10 修订日期：2019-11-03 |
| DOI：10.13241/j.cnki.pmb.2020.06.033 |
| 中文关键词: 脓毒症 FGF-21 MR-proADM 炎性因子 诊断 预后 |
| 英文关键词: Sepsis FGF-21 MR-proADM Inflammatory factors Diagnosis Prognosis |
| 基金项目:四川省卫生和计划生育委员会科研项目（17PJ1047） |
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| 中文摘要: |
| 摘要 目的：探讨血清人成纤维细胞生长因子-21（FGF-21）、肾上腺髓质素前体中段肽（MR-proADM）、炎性因子与脓毒症患者预后的关系。方法：选取2015年9月至2018年9月我院收治的脓毒症患者160例（脓毒症组），按病情严重程度分为轻度脓毒症组（A组）56例、严重脓毒症组（B组）53例，脓毒性休克组（C组）51例，另选取同期50例健康体检者作为健康对照组。检测各组血清FGF-21、MR-proADM和炎性因子[（白细胞（WBC），白细胞介素-6（IL-6），肿瘤坏死因子-?琢（TNF-?琢），白细胞介素-10（IL-10）]水平，记录脓毒症患者序贯性器官功能衰竭评分（SOFA）和急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分及28 d预后。采用受试者工作特征（ROC）曲线分析FGF-21、MR-proADM、炎性因子单独及联合评估脓毒症预后的价值。采用Spearman相关分析FGF-21、MR-proADM和炎性因子与APACHE Ⅱ评分、SOFA评分的相关性。结果：脓毒症组血清FGF-21、MR-proADM和炎性因子WBC、IL-6、TNF-α、IL-10水平均明显高于健康对照组(均P<0.05)，且随着脓毒症病情的加重，患者血清FGF-21、MR-proADM和炎性因子水平逐渐升高。脓毒症患者中28d死亡43例（26.88%），其中A组8例(14.29%)、B组12例(22.64%)、C组23例(45.10%)。ROC曲线分析显示，联合检测评估脓毒症患者病死率的曲线下面积（AUC）、敏感度及特异度均高于单一检测。脓毒症患者血清FGF-21、MR-proADM、WBC、IL-6、TNF-α与APACHE Ⅱ评分及SOFA评分均呈正相关性(P<0.05)，此外，IL-10与SOFA评分呈正相关性（P<0.05），与APACHEⅡ评分无相关性（P>0.05）。结论：脓毒症患者血清FGF-21、MR-proADM水平升高，检测FGF-21、MR-proADM和炎性因子有助于评估脓毒症患者的病情及预后。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum human fibroblast growth factor-21 (FGF-21), adrenomedullin propeptide (MR-proADM), inflammatory factors and prognosis in patients with sepsis. Methods: A total of 160 patients with sepsis who were admitted to our hospital from September 2015 to September 2018 were selected as(sepsis group). According to the severity of the disease, they were divided into mild sepsis group (group A) 56 cases. There were 53 cases of severe sepsis group (group B) and 51 cases of septic shock group (group C). Another 50 healthy subjects were selected as healthy control group. Serum FGF-21, MR-proADM and inflammatory factors [white blood cells (WBC), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10)] were detected in each group. The sequential organ failure score (SOFA) and acute physiology and chronic health status scoring system II (APACHE II) scores and 28-day prognosis in patients with sepsis were recorded. The value of FGF-21, MR-proADM and inflammatory factors alone and in combination to evaluate the prognosis of sepsis was analyzed by receiver operating characteristic curve (ROC). Spearman correlation was used to analyze the correlation between FGF-21, MR-proADM and inflammatory factors and APACHE II score, SOFA score. Results: The levels of serum FGF-21, MR-proADM and inflammatory factors WBC, IL-6, TNF-α and IL-10 in sepsis group were significantly higher than those in healthy control group (all P<0.05), and with sepsis the severity of the disease increased, and the serum levels of FGF-21, MR-proADM and inflammatory factors gradually increased. 43 cases (26.88%) died in 28 days mortality in patients with sepsis, including 8 patients in group A(14.29%), 12 patients in group B(22.64%), and 23 patients in group C(45.10%). ROC curve analysis showed that the area under the curve (AUC), sensitivity and specificity of combined detection in evaluating mortality of sepsis patients were higher than those of single detection. Serum FGF-21, MR-proADM, WBC, IL-6, TNF-α were positively correlated with APACHE II score and SOFA score in patients with sepsis (P<0.05). In addition, IL-10 was positively correlated with SOFA score (P<0.05), and it was not associated with APACHE II score (P>0.05). Conclusion: Serum levels of FGF-21 and MR-proADM are elevated in patients with sepsis. Detection of FGF-21, MR-proADM and inflammatory factors can be used to evaluate the condition and prognosis of patients with sepsis. |
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