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肝素结合蛋白对严重多发伤患者细菌感染的预测价值。

The predictive value of heparin-binding protein for bacterial infections in patients with severe polytrauma.

作者信息

Li Li, Tian Xiao-Xi, Feng Gui-Long, Chen Bing

机构信息

Department of Critical Care Medicine, The Second Hospital of Tianjin Medical University, Tianjin, China.

Department of Emergency, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.

出版信息

PLoS One. 2024 Dec 26;19(12):e0300692. doi: 10.1371/journal.pone.0300692. eCollection 2024.

Abstract

INTRODUCTION

Heparin-binding protein is an inflammatory factor with predictive value for sepsis and participates in the inflammatory response through antibacterial effects, chemotaxis, and increased vascular permeability. The role of heparin-binding protein in sepsis has been progressively demonstrated, but few studies have been conducted in the context of polytrauma combined with bacterial infections. This study aims to investigate the predictive value of heparin-binding protein for bacterial infections in patients with severe polytrauma.

MATERIALS AND METHODS

This is a prospective single-center study. Patients with polytrauma in the emergency intensive care unit were selected for the study, and plasma heparin-binding protein concentrations and other laboratory parameters were measured within 48 hours of admission to the hospital. A two-sample comparison and univariate logistic regression analysis investigated the relationship between heparin-binding protein and bacterial infection in polytrauma patients. A multifactor logistic regression model was constructed, and the ROC curve was plotted.

RESULTS

Ninety-seven patients with polytrauma were included in the study, 43 with bacterial infection and 54 without infection. Heparin-binding protein was higher in the infected group than in the control group [(32.00±3.20) ng/mL vs. (18.52±1.33) ng/mL, P = 0.001]. Univariate logistic regression analysis shows that heparin-binding protein is related to bacterial infection (OR = 1.10, Z = 3.91, 95%CI:1.051.15, P = 0.001). Multivariate logistic regression equations showed that patients were 1.12 times more likely to have bacterial infections for each value of heparin-binding protein increase, holding neutrophils and Procalcitonin (PCT) constant. ROC analysis shows that heparin-binding protein combined with neutrophils and PCT has better predictive value for bacterial infection [AUC = 0.935, 95%CI:0.8700.977].

CONCLUSIONS

Heparin-binding protein may predict bacterial infection in patients with severe polytrauma. Combining heparin-binding protein, PCT, and neutrophils may improve bacterial infection prediction.

摘要

引言

肝素结合蛋白是一种对脓毒症具有预测价值的炎症因子,通过抗菌作用、趋化作用和增加血管通透性参与炎症反应。肝素结合蛋白在脓毒症中的作用已逐步得到证实,但在多发伤合并细菌感染的情况下开展的研究较少。本研究旨在探讨肝素结合蛋白对严重多发伤患者细菌感染的预测价值。

材料与方法

这是一项前瞻性单中心研究。选取急诊重症监护病房的多发伤患者进行研究,在入院48小时内测定血浆肝素结合蛋白浓度及其他实验室参数。采用两样本比较和单因素逻辑回归分析探讨多发伤患者肝素结合蛋白与细菌感染之间的关系。构建多因素逻辑回归模型并绘制ROC曲线。

结果

本研究纳入97例多发伤患者,其中43例发生细菌感染,54例未感染。感染组肝素结合蛋白水平高于对照组[(32.00±3.20)ng/mL对(18.52±1.33)ng/mL,P = 0.001]。单因素逻辑回归分析显示,肝素结合蛋白与细菌感染有关(OR = 1.10,Z = 3.91,95%CI:1.05~1.15,P = 0.001)。多因素逻辑回归方程显示,在中性粒细胞和降钙素原(PCT)不变的情况下,肝素结合蛋白每升高一个单位,患者发生细菌感染的可能性增加1.12倍。ROC分析显示,肝素结合蛋白联合中性粒细胞和PCT对细菌感染具有更好的预测价值[AUC = 0.9

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0131/11670932/ce259aa7d1de/pone.0300692.g001.jpg

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