血清HDL-C联合PCT、CRP、IL-6检测在评估腹腔感染患者严重程度中的价值

目的探讨高密度脂蛋白胆固醇(HDL-C)联合降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)检测在评估腹腔感染患者严重程度中的价值。方法选取华中科技大学同济医学院附属同济医院2018年1月至2019年7月收治的116例腹腔疾病患者为研究对象,依据感染程度不同分为复杂腹腔感染组45例,单纯腹腔感染组37例,以及无感染的对照组34例。分别检测3组患者在治疗前及治疗后血清中HDL-C、PCT、CRP、IL-6和白细胞(WBC)水平,统计患者序贯脏器衰竭评分(SOFA评分),分析其与感染程度的相关性。结果治疗前,复杂腹腔感染组中患者血清HDL-C显著低于单纯腹腔感染组及对照组(P<0.05),PCT、CRP、IL-6和WBC显著高于单纯腹腔感染组及对照组(P<0.05)。受试者工作特征曲线(ROC曲线)分析结果显示,HDL-C、PCT、CRP、IL-6、WBC联合检测的曲线下面积为0.972,均高于PCT(0.961)、HDL-C(0.877)、IL-6(0.766)、WBC(0.686)和CRP(0.661)单独检测。治疗后,复杂腹腔感染组及单纯腹腔感染组中患者血清HDL-C上升,PCT、CRP、IL-6和WBC下降,与治疗前比较,差异均有统计学意义(P<0.05)。复杂腹腔感染组中死亡患者血清HDL-C低于好转出院患者(P<0.05),SOFA评分明显高于好转出院患者(P<0.05),而PCT、CRP、IL-6和WBC差异无统计学意义(P>0.05)。结论临床检测腹腔感染患者血清中HDL-C、PCT、CRP、IL-6及WBC水平对评估患者感染的严重程度及治疗效果有一定的指导作用,治疗过程中患者血清HDL-C持续性处于较低水平可能提示预后不良。

Value of combined detection of HDL-C,PCT,CRP and IL-6 in assessment of the degree of patients with abdominal infection

Objective To investigate the value of combined detection of high density lipoprotein cholesterol(HDL-C),procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6)in assessment of the degree of infection in patients with abdominal infection.Methods A total of 116 patients with celiac disease from January 2018 to July 2019 were selected.According to the degree of infection,patients were divided into complicated abdominal infection group(45 cases),simple abdominal infection group(37 cases)and non-infection group(34 cases).The levels of serum HDL-C,PCT,CRP,IL-6 and white blood cell(WBC)were measured at the beginning and end of treatment.The sequential organ failure score(SOFA score)of patients in each group were measured,and their correlation with the infection degree were analyzed.Results At the beginning of treatment,the serum HDL-C level in complicated abdominal infection group was significantly lower than that of simple abdominal infection group and non-infection group(P<0.05),while PCT,CRP,IL-6 and WBC were significantly higher than that of simple abdominal infection group(P<0.05).The area under ROC curve(AUC)of combined detection of HDL-C,PCT,CRP,IL-6 and WBC were 0.972,which was significantly higher than AUC of single detection of PCT(0.961),HDL-C(0.877),IL-6(0.766),WBC(0.686)and CRP(0.661).At the end of treatment,the serum HDL-C significantly increased and PCT,CRP,IL-6 and WBC significantly decreased in the complicated abdominal infection group and the simple abdominal infection group(P<0.05).The serum HDL-C of the dead patients in the complicated abdominal infection group was significantly lower than that of the discharged patients with improvement(P<0.05),the average SOFA scores were significantly higher than that of the discharged patients with improvement(P<0.05),while PCT,CRP,IL-6 and WBC had no statistical difference(P>0.05).Conclusion Clinical detection of serum HDL-C,PCT,CRP,IL-6 and WBC in patients with abdominal infection has a certain guiding role in clinical evaluation of the severity of infection and intervention treatment.The persistence lower level of serum HDL-C in patients with abdominal infection during treatment may indicate poor prognosis.