血浆组织型激肽释放酶可评估脓毒症严重程度及预后

王玢然.血浆组织型激肽释放酶可评估脓毒症严重程度及预后[J].内科急危重症杂志,2025,31(2):149-153

DOI：10.11768/nkjwzzzz20250211

英文关键词:

基金项目:国家自然科学基金（82271358）

作者	单位	E-mail
王玢然	华中科技大学同济医学院附属同济医院	ranxiao1001@tjh.tjmu.edu.cn

摘要点击次数: 75

全文下载次数: 109

中文摘要:

摘要目的：探讨血浆组织型激肽释放酶(TK)对脓毒症诊断、病情严重程度及其预后的评估价值。方法：选取重症医学科收治的192例全身炎症反应综合征(SIRS)及脓毒症患者为研究对象，根据病情严重程度分为SIRS组(42例)、脓毒症组(62例)和脓毒性休克组(88例)。另选取非感染患者76例为对照组。检测各组血浆TK含量及活性、尿液TK活性。采用受试者工作特征（ROC）曲线评估TK含量及活性对脓毒症的临床诊断价值；采用非条件Logistics回归分析评价各指标与28d生存率的相关性。结果：SIRS组及脓毒症组患者血浆TK含量及活性高于对照组，且脓毒症组高于SIRS组(P均<0.05)，而组间尿液TK活性比较，差异无统计学意义(P均>0.05)。血浆TK含量诊断脓毒症的ROC曲线下面积为0.862，当血浆TK含量为0.340mg/L时，其诊断脓毒症的灵敏度为0.829，特异性为0.857；血浆TK含量与28d生存率密切相关（OR=0.63, 95%CI 0.46~0.85, P<0.05）。结论：血浆TK含量可以用于诊断脓毒症，评估病情严重程度及其预后。

英文摘要:

Abstract bjective: To explore the value of tissue kallikrein (TK) in the diagnosis, severity, and prognosis of sepsis. Methods: In total, 192 patients with systemic inflammatory response syndrome (SIRS) and sepsis admitted to the intensive care unit were selected as the research subjects. According to the severity of the condition, the patients were divided into SIRS group (42 cases), sepsis group (62 cases), and septic shock group (88 cases). Another 76 non-infected patients were selected as the control group. The plasma TK content and activity, and urine TK activity in each group of patients were determined. Receiver operating characteristic (ROC) curve was drawn to evaluate the clinical diagnostic value of TK content and activity in sepsis. Non conditional logistics regression analysis was used to evaluate the correlation between various indicators and 28-day survival rate. Results: The plasma TK content and activity in the SIRS group and sepsis group were higher than the control group, and those in the sepsis group were higher than those in the SIRS group (all P<0.05). However, there was no significant difference in urine TK activity between the groups (all P> 0.05). The area under the ROC curve for diagnosing sepsis with plasma TK content was 0.862 (P< 0.05). When the plasma TK content was 0.340mg/L, the sensitivity and specificity for distinguishing sepsis were 0.829 and 0.857, respectively. The plasma TK content was closely related to the 28-day survival rate (OR=0.63, 95%CI 0.46-0.85, P<0.05). Conclusion: Plasma TK content can be used for diagnosing sepsis, assessing the severity of the condition, and predicting its prognosis.