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使用新型标志物组合对重症监护病房脓毒症第 1 天进行死亡率预测。

Mortality prediction using a novel combination of biomarkers in the first day of sepsis in intensive care units.

机构信息

Dermatology Department, Xiangya Medical College, Central South University, Changsha, Hunan, China.

Emergency Department, Shenzhen People's Hospital (The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University), Shenzhen, Guangdong, China.

出版信息

Sci Rep. 2021 Jan 14;11(1):1275. doi: 10.1038/s41598-020-79843-5.

Abstract

Early identification of infection severity and organ dysfunction is crucial in improving outcomes of patients with sepsis. We aimed to develop a new combination of blood-based biomarkers that can early predict 28-day mortality in patients with sepsis or septic shock. We enrolled 66 patients with sepsis or septic shock and compared 14 blood-based biomarkers in the first 24 h after ICU admission. The serum levels of interleukin-6 (IL-6) (median 217.6 vs. 4809.0 pg/ml, P = 0.001), lactate (median 2.4 vs. 6.3 mmol/L, P = 0.014), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) (median 1596.5 vs. 32,905.3 ng/ml, P < 0.001), prothrombin time (PT) (median 15.6 vs. 20.1 s, P = 0.030), activated partial thrombin time (APTT) (median 45.1 vs. 59.0 s, P = 0.026), and international normalized ratio (INR) (median 1.3 vs. 1.8, P < 0.001) were significantly lower in the survivor group. IL-6, NT-proBNP, and INR provided the best individual performance in predicting 28-day mortality of patients with sepsis or septic shock. Furthermore, the combination of these three biomarkers achieved better predictive performance (AUC 0.890, P < 0.001) than conventional scoring systems. In summary, the combination of IL-6, NT-proBNP, and INR may serve as a potential predictor of 28-day mortality in critically ill patients with sepsis or septic shock.

摘要

早期识别感染严重程度和器官功能障碍对于改善脓毒症患者的预后至关重要。我们旨在开发一种新的血液生物标志物组合,以早期预测脓毒症或感染性休克患者的 28 天死亡率。我们纳入了 66 例脓毒症或感染性休克患者,并比较了入院后 24 小时内的 14 种血液生物标志物。白细胞介素-6(IL-6)(中位数 217.6 与 4809.0 pg/ml,P = 0.001)、乳酸(中位数 2.4 与 6.3 mmol/L,P = 0.014)、脑钠肽前体 N 末端(NT-proBNP)(中位数 1596.5 与 32905.3 ng/ml,P < 0.001)、凝血酶原时间(PT)(中位数 15.6 与 20.1 s,P = 0.030)、活化部分凝血活酶时间(APTT)(中位数 45.1 与 59.0 s,P = 0.026)和国际标准化比值(INR)(中位数 1.3 与 1.8,P < 0.001)在存活组中显著降低。IL-6、NT-proBNP 和 INR 在预测脓毒症或感染性休克患者 28 天死亡率方面具有最佳的个体表现。此外,这三种生物标志物的组合具有更好的预测性能(AUC 0.890,P < 0.001),优于传统评分系统。总之,IL-6、NT-proBNP 和 INR 的组合可能成为危重症脓毒症或感染性休克患者 28 天死亡率的潜在预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29bb/7809407/dc7c2de0b36c/41598_2020_79843_Fig1_HTML.jpg

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