脓毒症患者连续性血液净化治疗前后PCT Trx-1 D-Lac表达及意义

doi:10.3969/j.issn.1006-6233.2024.01.09

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Abstract Objective: To investigate the changes of serum procalcitonin (PCT), thioredoxin (Trx-1) and D-lactic acid (D-Lac) levels before and after continuous blood purification (CBP) treatment in patients with sepsis, and to analyze its predictive value and clinical significance for the efficacy of CBP. Methods: A total of 100 patients with sepsis in our hospital from January 2021 to December 2022 were selected as the observation group, and 100 healthy subjects were selected as the control group according to the 1:1 pairing principle. The serum PCT, Trx-1 and D-Lac levels of the two groups were analyzed. Observation group received CBP treatment and was divided into survival subgroup and death subgroup according to treatment effect. The serum levels of PCT, Trx-1, D-Lac, acute physiology and chronic health status Ⅱ score (APACHEⅡ) were compared between different subgroups and the difference before and after treatment. Pearson correlation analysis was performed to assess the correlation between the changes in serum biomarker levels and APACHE II scores. Receiver operating characteristic curve (ROC) and area under curve (AUC) were used to analyze the predictive value of the difference in the level of each serum indicator. Kaplan-Meier was used to analyze the survival status of patients with different serum expressions within 28 days. Results: The serum levels of PCT, Trx-1 and D-Lac in observation group were higher than those in control group (P<0.05). After 1 week of treatment, the levels of serum PCT, Trx-1, D-Lac and APACHEⅡ score in death subgroup were higher than those in survival subgroup, and the difference was smaller than that in survival subgroup (P<0.05). There was a positive correlation between the difference of serum indexes and APACHEⅡ score (P<0.05). The AUC of the combined prediction of CBP was greater than that of the single prediction and the combined prediction of the serum prediction (P<0.05). The risk of death in patients with high expression of PCT, Trx-1 and D-Lac was 4.828, 3.600 and 2.318 times of that in patients with low expression, respectively, and the survival rate was higher than that in patients with low expression (P<0.05). Conclusion: The changes of serum PCT, Trx-1 and D-Lac levels in sepsis patients before and after CBP treatment can reflect the severity of the disease, and are closely related to the survival within 28 days. The combined detection of the changes has a certain predictive value for the efficacy of CBP.

Key words： Sepsis Continuous blood purification Procalcitonin Thioredoxin 1 D-lactic acid

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.01.09 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I1/50

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