血清CRP、CD25+、B型脑钠肽及高迁移率族蛋白B1在脓毒症中的表达及意义

目的探讨血清C反应蛋白(CRP)、CD25+、B型脑钠肽(BNP)及高迁移率族蛋白B1(HMGB1)在脓毒症中的表达及意义。方法选择2017年5月-2019年5月于苏州市立医院北区进行治疗的80例脓毒症患者进行研究,设为观察组,选择同期于本院进行体检的健康人群为对照组。分析脓毒症患者中血清CRP、CD25+、BNP及HMGB1的表达及其诊断价值。结果观察组患者血清CRP、CD25+、BNP及HMGB1水平显著高于对照组,差异显著(P<0.05);脓毒症组悲者血清CRP、CD25+、BNP及HMGB1水平显著低于严重脓毒症组脓毒症休克组患者;严重脓毒症组患者血清CRP、CD25+、BNP及HMGB1水平显著低于脓毒症休克组患者,差异显著(P<0.05);CRP诊断脓毒症的AUC为0.984,95%CI为0.959~0.1.000,CD25+诊断脓毒症的AUC为0.967,95%CI为0.944~0.990,BNP诊断脓毒症的AUC为0.960,95%CI为0.933~0.986,HMGB1诊断脓毒症的AUC为0.821,95%CI为0.751~0.892,联合检测诊断脓毒症的AUC为1.000,95%CI为1.000~1.000,单独检测分别和联合检测曲线下面积比较均具有显著差异(Z=2.231.2.750.2.857.4.972,P<0.05);联合检测的特异度、准确度分别为93.79%.94.15%。结论在脓毒症患者中CRP、CD25+、BNP及HMGB1的表达和疾病严重程度之间存在着密切关系,联合检测在诊断脓毒症时具有较高的准确度。

Expression of serum C reactive protein,CD25+,b-type brain natriuretic peptide and high-mobility group protein B1 in sepsis and significance thereof

Objective To study the expression of serum C-reactive protein(CRP),CD25+,b-type brain natriuretie peptide(BNP)and high-mobility group protein B1(HMGB1)in sepsis and significance thereof.Methods Peripheral venous blood samples were collected from 80 septic patients of which 21 suffering from general sepsis,37 from severe sepsis,and 22 from sepsis with shock 22(observation group),to undergo the examination of serum CRP,BNP,and HMCB1 by ELIZA,and CD25+by flow cytometer;and 70 baseline datamatched healthy people who underwent physical examination during the same period were selected as the control group.The diagnostic values of these inflammatory factors were analyzed.Results The serum levels of CRP,CD25+,BNP,and HMGB1 in the observation group were all significantly higher than those in the control group(all P<0.05).The serum levels of CRP,CD25+,BNP,and HMGB1 in the general sepsis subgroup were all significantly lower than those in the severe sepsis subgroup and the septie shock subgroup(all P<0.05).The serum levels of CRP,CD25+,BNP,and HMGB1 in the severe sepsis subgroup were all significantly lower than those in the septic shock subgroup(all P<0.05).The AUC of CRP in the diagnosis of sepsis was 0.984(with the 95%CI as 0.959~0.1.000),the AUC of CD25+in the diagnosis of sepsis was 0.967(with the 95%Clas 0.944~0.990),the AUC of BNP in the diagnosis of sepsis was 0.960(with the 95%CI as 0.933~0.986),and the AUC of HMCB1 in the diag-nosis of sepsis was 0.821(with the 95%CI as 0.751~0.892);and the AUC of joint detection in the diagnosis of sepsis was 1.000(with the 95%CI as 1.000~1.000).There was a significant difference between the area under the curve of the sepa-rate detection and the joint detection(Z=2.231,2.750,2.857,4.972,P<0.05).The specificity and accuracy of the joint detection were 93.79%and 94.15%,respectively.Conclusion the expressions of CRP,CD25+,BNP,and HMCB1 in sepsis patients are closely related to the severity of the disease.Joint detection shows a higher accuracy in diagnosis of sepsis.