ICU脓毒症患者血清S-100、APN水平与MODS发生及预后的相关性分析
Correlation analysis of serum S-100 and APN levels with the occurrence and prognosis of MODS in patients with sepsis in ICU

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中文关键词: 脓毒症多器官功能障碍综合征中枢神经特异蛋白脂联素重症加强护理病房预后

英文关键词:sepsis multiple Organ Dysfunction Syndrome central nervous specific protein adiponectin intensive intensive care unit prognosis

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作者	单位	邮编
贾椸琳	成都市第三人民医院	610000
唐江红	成都市第三人民医院	610000
张佳宁	成都市第三人民医院	610000

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中文摘要:

目的分析重症加强护理病房（ICU）脓毒症患者血清中枢神经特异蛋白（S-100）、脂联素（APN）水平与多器官功能障碍综合征（MODS)发生及预后的相关性。方法采取前瞻性研究，选择2022年5月至2023年5月医院收治的120例脓毒症患者作为研究对象。患者入院时均接受血清S-100蛋白检测（S-100β、S-100A8、S-100A9）、脂联素（APN）检测。根据患者住院期间MODS发生情况及入院后28d内存活情况进行分组，统计并比较患者基线资料。采用二元logistic回归、COX回归分析S-100β、S-100A8、S-100A9、APN水平与脓毒症患者MODS及预后的关系；采用绘制受试者工作特征曲线（ROC）分析血清S-100β、S-100A8、S-100A9、APN水平预测脓毒症患者MODS发生及预后不良的预测价值。结果 MODS组、预后不良组合并低血钙、合并高乳酸血症患者占比高于无MODS组、预后良好组，APACHE Ⅱ评分、血清S-100β、S-100A8、S-100A9水平高于无MODS组、预后良好组，APN低于无MODS组、预后良好组（P＜0.05）；二元logistic回归、COX分析结果显示，APACHE Ⅱ评分高、合并高乳酸血症及血清S-100β、S-100A8、S-100A9高表达是脓毒症患者并发MODS的危险因素（OR＞1，P＜0.05），血清APN高表达是脓毒症患者并发MODS及预后不良的保护因素（OR＜1，P＜0.05）；绘制ROC曲线，结果显示，血清S-100β、S-100A8、S-100A9、APN水平及联合检测预测脓毒症患者MODS发生、预后不良的AUC均＞0.70，有一定预测价值，其中联合检测最高。结论血清S-100、APN水平与ICU脓毒症患者MODS的发生及预后不良的关系密切，能够有效预测ICU脓毒症患者MODS发生及预后不良风险。

英文摘要:

Purpose The correlation between serum levels of central nervous specific protein (S-100) and adiponectin (APN) and the occurrence and prognosis of multiple organ dysfunction syndrome (MODS) in patients with sepsis in intensive care unit (ICU) was analyzed.Methods A prospective study was conducted to select 120 patients with sepsis admitted to the hospital from May 2022 to May 2023 as the study subjects. All patients received serum S-100 protein detection (S-100β, S-100A8, S-100A9) and adiponectin (APN) detection on admission. The patients were grouped according to the occurrence of MODS during hospitalization and the survival within 28 days after admission, and the baseline data of the patients were counted and compared.Binary logistic regression and COX regression were used to analyze the relationship between S-100β, S-100A8, S-100A9, APN levels and MODS and prognosis in patients with sepsis. The receiver operating characteristic curve (ROC) was used to analyze the predictive value of serum S-100β, S-100A8, S-100A9 and APN levels in predicting the occurrence of MODS and poor prognosis in patients with sepsis.Results The proportion of patients with hypocalcemia and hyperlactacidemia in MODS group and non-prognosis group was higher than that in non-MODS group and good prognosis group. APACHE II score, serum S-100β, S-100A8 and S-100A9 levels were higher than those in non-MODS group and good prognosis group, and APN was lower than that in non-MODS group and good prognosis group (OR > 1, P < 0.05). High expression of serum APN was a protective factor for MODS and poor prognosis in patients with sepsis (OR < 1, P < 0.05).The ROC curve was drawn. The results showed that the AUC of serum S-100β, S-100A8, S-100A9, APN levels and combined detection in predicting the occurrence and poor prognosis of MODS in patients with sepsis were all > 0.70, which had certain predictive value, and the combined detection was the highest.Conclusion Serum S-100 and APN levels are closely related to the occurrence and poor prognosis of MODS in ICU patients with sepsis, which can effectively predict the occurrence and poor prognosis of MODS in ICU patients with sepsis.

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