2022 年第 2 期 第 17 卷

成纤维细胞生长因子21和降钙素原及高密度脂蛋白胆固醇联合检测对脓毒症的诊断价值

The diagnostic value of combined detection of fibroblast growth factor-21, procalcitonin and high-density lipoprotein cholesterol in sepsis

作者：胡元慧李欢汤冬玲张平安

英文作者：Hu Yuanhui Li Huan Tang Dongling Zhang Ping′an

单位：武汉大学人民医院检验科，武汉430060

英文单位：Department of Clinical Laboratory Renmin Hospital of Wuhan University Wuhan 430060 China

关键词：脓毒症；成纤维细胞生长因子21；高密度脂蛋白胆固醇；降钙素原

英文关键词：Sepsis;Fibroblastgrowthfactor-21;High-densitylipoproteincholesterol;Procalcitonin

• 摘要：

• 目的  探讨成纤维细胞生长因子21（FGF-21）、降钙素原及高密度脂蛋白胆固醇（HDL-C）联合检测对脓毒症的临床诊断价值。方法  选取2020年9月至2021年8月武汉大学人民医院收治的脓毒症患者136例（脓毒症组）、同期普通感染患者82例（非脓毒症组）和同期常规健康体检者83例（对照组）作为研究对象。分别测定3组FGF-21、降钙素原与HDL-C水平。采用二元Logistic回归分析方法得到FGF-21、降钙素原与HDL-C联合的回归模型，并绘制FGF-21、降钙素原及HDL-C单独或联合检测的受试者工作特征（ROC）曲线，计算曲线下面积（AUC）及敏感度、特异度和约登指数。结果  3组性别比例与年龄差异均无统计学意义（均P>0.05）。脓毒症组FGF-21与降钙素原水平明显高于非脓毒症组和对照组；非脓毒症组FGF-21与降钙素原水平明显高于对照组；脓毒症组HDL-C水平明显低于非脓毒症组和对照组，非脓毒症组HDL-C水平明显低于对照组，差异均有统计意义（均P<0.01）。ROC曲线分析结果显示FGF-21、降钙素原及HDL-C联合诊断的AUC为0.884，其95%置信区间为0.806～0.962，敏感度为87.2%，特异度为89.9%，AUC和约登指数大于各指标单独检测。结论  FGF-21、降钙素原及HDL-C联合检测提高了脓毒症的诊断效能，具有较高的临床价值。

• Objective To investigate the clinical diagnostic value of combined detection of fibroblast growth factor-21 (FGF-21), procalcitonin and high-density lipoprotein cholesterol (HDL-C) in sepsis. Methods From September 2020 to August 2021, 136 patients with sepsis(sepsis group), 82 patients with common infection(non-sepsis group) and 83 patients undergoing routine physical examination(control group) in Renmin Hospital of Wuhan University were selected. The levels of FGF-21, procalcitonin and HDL-C were measured in the three groups. Binary Logistic regression analysis was used to obtain the regression model of FGF-21, procalcitonin and HDL-C combined. The receiver operating characteristic (ROC) curve of FGF-21, procalcitonin and HDL-C alone or in combination was drawn to calculate the area under the curve (AUC), sensitivity, specificity and Youden index. Results There were no significant differences in gender and age among the three groups(both P>0.05). The levels of FGF-21 and procalcitonin in the sepsis group were significantly higher than those in the non-sepsis group and control group, and those in the non-sepsis group were significantly higher than those in the control group; the level of HDL-C in the sepsis group was significantly lower than that in the non-sepsis group and control group, and that in the non-sepsis group was significantly lower than that in the control group(all P<0.01). ROC curve analysis showed that the AUC of the combined diagnosis of FGF-21, procalcitonin and HDL-C was 0.884, 95% confidence interval: 0.806-0.962, the sensitivity was 87.2%, and the specificity was 89.9%. The AUC and Youden index of those combined diagnosis were greater than those detected separately. Conclusion The combined detection of FGF-21, procalcitonin and HDL-C improves the diagnostic efficiency of sepsis and has high clinical value.