肠三叶因子对脓毒性休克患者早期肠功能障碍的评估价值及与病情严重程度的关系

doi:10.3969/j.issn.1006-6233.2020.08.029

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Abstract Objective: To investigate the value of the evaluation of intestinal trefoil factor (TFF3) in early intestinal dysfunction in septic shock patients and its relationship with the severity of the disease. Methods: From November 2016 to October 2019, 150 patients with septic shock within 24 hours after admission in the Department of critical medicine of Dazhou Central Hospital were selected as the study objects. According to whether early intestinal dysfunction was complicated during hospitalization, they were divided into non intestinal dysfunction group (n = 72) and intestinal dysfunction group (n = 78). Clinical data were collected and serum TFF3 was detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Pearson test was used to analyze the correlations between serum TFF3 level and Acute Physiology And Chronic Health Evaluation Ⅱ (APACHE Ⅱ), C-reactive protein (CRP), blood urea nitrogen (BUN), blood creatinine (SCr) and gastrointestinal function score; multivariate logistic regression analysis of binary variables was used to screen the independent risk factors of early intestinal dysfunction in septic shock patients; and the ROC curve was drawn to evaluate the predictive values of APACHE Ⅱ score, SCr and TFF3 in patients with septic shock complicated with early intestinal dysfunction. Results: The APACHE Ⅱ score, levels of CRP, BUN, SCr and serum TFF3 of patients in intestinal dysfunction group were significantly higher than those of patients in non intestinal dysfunction group (P<0.05). There was a positive correlation between serum TFF3 level and APACHE Ⅱ score, CRP, BUN, SCr and gastrointestinal function score (P<0.05). Multivariate logistic regression analysis showed that the increases of APACHE Ⅱ score, SCr and serum TFF3 level were independent risk factors for septic shock complicated with early intestinal dysfunction (P<0.05). The ROC curve showed that the area under the curve (AUC) of serum TFF3 level in patients with septic shock complicated with early intestinal dysfunction was higher than that of APACHE Ⅱ score and SCr, and the sensitivity and specificity were 82.10% and 98.60% respectively when the best cutoff value was 12.97 ng/ml. Conclusions: The serum TFF3 level of septic shock patients with early intestinal dysfunction is increased, which can be used as a serum marker to evaluate the early intestinal dysfunction of septic shock patients.

Key words： Sepsis Septic shock Intestinal dysfunction Intestinal trefoil factor

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.08.029 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I8/1357

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