目的: 探讨正五聚蛋白-3(PTX3)对创伤后脓毒症早期预测和预后评估的价值。方法: 对2019年7月至2021年6月XXX医院收治的103例创伤患者进行回顾性分析,根据是否引发脓毒症将其分为脓毒症组(A组)和非脓毒症组(B组),A组患者36例,B组67例;另根据预后将脓毒症组患者分为生存出院组(A1组)和死亡组(A2组),A1组患者28例,A2组患者8例。分别对A组和B组、A1组和A2组的年龄、性别、种族、创伤严重程度(ISS)评分、损伤部位、降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素6(IL-6)、白细胞计数(WBC)、N末端C型钠尿肽前体(NT-proCNP)及PTX3、急性生理性及慢性健康状况评分系统评分(APACHE Ⅱ)、序贯器官衰竭评分(SOFA)等信息进行分析。结果: 与B组比较,A组PCT水平、CRP水平、PTX3水平、APACHEⅡ评分、SOFA评分更高(P＜0.05);PTX3在创伤后脓毒症早期预测中的敏感度、特异度均高于PCT、CRP、APACHEⅡ评分、SOFA评分(P＜0.05);与A1组比较,A2组PCT水平、CRP水平、PTX3水平、APACHEⅡ评分、SOFA评分更高(P＜0.05);PCT、CRP、PTX3、APACHEⅡ评分、SOFA评分在创伤后脓毒症预后评估中的敏感度比较均无差异(P＞0.05),PTX3在创伤后脓毒症预后评估中的特异度均比PCT、CRP、APACHEⅡ评分、SOFA评分高(P＜0.05);PTX3在创伤后脓毒症评估中的敏感度和特异度均比PCT、CRP、APACHEⅡ评分、SOFA评分高(P＜0.05)。结论: PTX3与创伤后脓毒症的发生及其预后存在一定关联,可根据其指标水平变化情况早期预测创伤后脓毒症,同时还能有效评估其预后。

Objective: To investigate the value of pentraxin-3 (PTX3) in early prediction and prognosis evaluation of post-traumatic sepsis. Methods: A retrospective analysis was performed on 103 trauma patients admitted to our hospital from July 2019 to June 2021,and they were divided into sepsis group (group A) and non-sepsis group (group B) according to whether they caused sepsis or not. There were 36 patients in group A and 67 patients in group B. According to the prognosis,the patients in the sepsis group were divided into a survival and discharge group (group A1) and a death group (group A2). There were 28 patients in group A1,There were 8 patients in group A2. Age,sex,race,trauma severity (ISS) score,injury site,procalcitonin (PCT),C-reactive protein (CRP),and interleukin were compared in groups A and B,A1 and A2,respectively. 6 (IL-6),white blood cell count (WBC),N-terminal precursor c-type natriuretic peptide (NT-proCNP) and PTX3,acute physiology and chronic health status scoring system score (APACHE Ⅱ,sequential organ failure score ( Sofa) and other information for analysis. Results: Compared with group B,group A had higher levels of PCT,CRP,PTX3,APACHEⅡ score and SOFA score (P＜0.05); the sensitivity and specificity of PTX3 in early prediction of post-traumatic sepsis were higher than those in group A (P＜0.05). PCT,CRP,APACHEⅡ score,SOFA score (P＜0.05); compared with A1 group,A2 group had higher PCT level,CRP level,PTX3 level,APACHE Ⅱ score,SOFA score (P＜0.05); There was no difference in the sensitivity of PCT,CRP,PTX3,APACHE Ⅱ score and SOFA score in the prognosis evaluation of post-traumatic sepsis (P＞0.05). CRP,APACHE Ⅱ score and SOFA score were higher (P＜0.05). The sensitivity and specificity of PTX3 in the assessment of post-traumatic sepsis were higher than those of PCT,CRP,APACHE Ⅱscore and SOFA score (P＜0.05). Conclusion: PTX3 has a certain relationship with the occurrence and prognosis of post-traumatic sepsis. It can predict post-traumatic sepsis early according to the changes of its index levels,and can also effectively evaluate its prognosis.