血清SAA和ACTH表达水平与重症细菌感染性疾病的关系及对患者治疗效果的评估

目的探讨血清淀粉样蛋白A(SAA)和促肾上腺皮质激素(ACTH)表达水平与重症细菌感染性疾病的关系,分析其对患者治疗效果的评估价值。方法选取秦皇岛市第一医院2018年1月至2019年1月重症监护室收治的126例感染性疾病患者,根据微生物培养结果分为细菌感染组(n=74)和非细菌感染组(n=52),另选取同期60例体检健康者为对照组。对比各组血清SAA、ACTH水平及白细胞计数(WBC),观察细菌感染组治疗后各时间段血清SAA、ACTH水平及WBC和序贯器官衰竭估计评分(SOFA)评分变化;ROC曲线分析血清SAA、ACTH水平及WBC对重症细菌感染性疾病的诊断价值。结果细菌感染组血清SAA、ACTH水平及WBC值明显高于非细菌感染组(P<0.001),且感染组血清SAA、ACTH水平及WBC值明显高于对照组(P<0.001);细菌感染组治疗后1 d、7 d、14 d、出院前血清SAA、ACTH水平及WBC和SOFA评分逐渐降低。ROC曲线显示,WBC诊断重症细菌感染性疾病的AUC与SAA、ACTH诊断差异无统计学意义(P>0.05),SAA联合ACTH诊断重症细菌感染...

Relationship between serum SAA and ACTH expression levels and severe bacterial infectious diseases and evaluation of therapeutic effect on patients

Objective To explore the relationship between serum amyloid A(SAA)and adrenocorticotropic hormone(ACTH)expression levels and severe bacterial infectious diseases,and to analyze the evaluation value of their therapeutic effect on patients.Methods A total of 126 patients with infectious diseases admitted to the intensive care unit of Qinhuangdao First Hospital from January 2018 to January 2019 were selected.According to the results of microbial culture,they were divided into bacterial infection group(n=74)and non-bacterial infection group(n=52),and 60 healthy subjects during the same period were selected as control group.Serum SAA and ACTH levels and white blood cell count(WBC)in each group were compared,and the changes of serum SAA and ACTH levels,WBC and sequential organ failure assessment(SOFA)scores in the bacterial infection group at each time after treatment were observed.The diagnostic value of serum SAA and ACTH levels and WBC in severe bacterial infectious diseases were analyzed by ROC curve.Results The serum SAA,ACTH and WBC values in the bacterial infection group were significantly higher than those in non-bacterial infection group(P<0.001),and the serum SAA,ACTH and WBC values in bacterial infection group were significantly higher than those in the control group(P<0.001).Serum SAA,ACTH,WBC and SOFA scores in the bacteri-al infection group decreased gradually 1 d,7 d,14 d after treatment and before discharge.ROC curve showed that there was no significant difference between WBC and SAA and ACTH in AUC diagnosis(P>0.05).SAA combined with ACTH in AUC diagnosis of severe bacterial infections was significantly higher than WBC,SAA and ACTH diagnosis(P<0.05),and the sensitivity and specificity were the highest.Conclusion The serum SAA and ACTH levels of patients with severe bacterial infectious diseases are significantly increased,which can be used to monitor the treatment effect in real time.The combined detection of serum SAA and ACTH levels can improve the diagnostic value of severe bacterial infectious diseases.