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Received:October 16, 2023 Published Online:November 20, 2024
Received:October 16, 2023 Published Online:November 20, 2024
中文摘要: 目的 分析血清白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、淀粉样蛋白A(SAA)联合检测对老年脓毒症合并急性肺损伤(ALI)患者预后的预测价值。方法 选择成都医学院附属老年医院2021年5月至2023年5月就诊的50例老年脓毒症患者为对照组,50例老年脓毒症伴ALI患者为观察组,以及50例老年健康体检者为健康组。根据氧合指数(OI)将脓毒症伴ALI患者分为低危组(27例,OI为201~300 mmHg)、中危组(15例,101~200 mmHg)和高危组(8例,OI≤100 mmHg),根据患者临床结局将老年脓毒症伴ALI患者分为存活组(42例)和死亡组(8例),比较各组血清IL-6、hs-CRP、SAA水平及APACHEⅡ评分,绘制受试者工作特征(ROC)曲线分析血清IL-6、hs-CRP、SAA对患者死亡的预测效能。结果 观察组血清IL-6、hs-CRP、SAA水平和APACHEⅡ评分均高于对照组和健康组(P<0.05)。高危组血清IL-6、hs-CRP、SAA水平和APACHEⅡ评分均高于中危组和低危组(P<0.05)。死亡组血清IL-6、hs-CRP、SAA水平和APACHEⅡ评分均高于存活组(P<0.05)。血清IL-6、hs-CRP、SAA联合检测预测老年脓毒症合并ALI死亡的曲线下面积最高,为0.859(95%CI 0.812~0.952),灵敏度为94.96%,特异度为90.38%。结论 老年脓毒症伴ALI血清IL-6、hs-CRP、SAA水平高,与ALI严重程度及预后联系密切,联合检测可提高对患者临床结局的预测效能。
Abstract:Objective To analyze the prognostic predictive value of combined serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and amyloid A (SAA) tests in elderly patients with sepsis combined with acute lung injury (ALI). Methods From May 2021 to May 2023, 50 elderly patients with sepsis (control group), 50 elderly patients with sepsis complicated with ALI (observation group), and 50 elderly healthy subjects (healthy group) admitted in the Affiliated Elderly Hospital of Chengdu Medical College were selected. Patients in observation group were divided into low-risk group (27 cases, 201-300 mmHg), medium-risk group (15 cases, 101-200 mmHg) and high-risk group (8 cases, ≤100 mmHg) according to oxygenation index (OI), and were divided into survival group (42 cases) and death group (8 cases) according to clinical outcomes. Serum levels of IL-6, hs-CRP, SAA and APACHEⅡ scores were compared between each group. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of serum IL-6, hs-CRP and SAA on death. Results The levels of serum IL-6, hs-CRP, SAA and APACHEⅡ score in observation group were higher than those in control group and healthy group (P<0.05). The levels of IL-6, hs-CRP, SAA and APACHEⅡ score in high-risk group were higher than those in medium-risk group and low-risk group (P<0.05). The levels of IL-6, hs-CRP, SAA and APACHEⅡ score in the death group were higher than those in the survival group (P<0.05). The area under the curve of the combined detection of serum IL-6, hs-CRP and SAA to predict the death of sepsis complicated with ALI was the highest [0.859, 95%CI (0.812-0.952)], with the sensitivity of 94.96% and specificity of 90.38%. Conclusion High levels of serum IL-6, hs-CRP, and SAA in elderly sepsis with ALI are closely associated with the severity and prognosis of ALI, and the combined assay can improve the efficacy of predicting the clinical outcome of patients.
文章编号: 中图分类号:R631 文献标志码:A
基金项目:国家自然科学基金(81960342)
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