| 摘要: |
| ［摘要］ 目的 分析脓毒症患者D-二聚体（D-D）、25-羟基维生素D［25（OH）D］、淋巴细胞/单核细胞比值（LMR）、白细胞介素-6（IL-6）水平及临床意义。方法 选取2022年6月至2024年6月陆军第七十三集团军医院收治的55例脓毒症患者作为观察组。另选取同期50名体检健康者作为对照组。检测患者入院时、对照组体检时血浆D-D水平和血清25（OH）D、IL-6水平并计算LMR。根据患者入院后3个月内的存活情况将其分为死亡组（15例）和存活组（40例）。采用多因素logistic回归分析脓毒症患者发生死亡的影响因素。通过受试者工作特征（ROC）曲线分析D-D、25（OH）D、LMR、IL-6对脓毒症患者发生死亡的预测效能。结果 观察组D-D、IL-6水平高于对照组，25（OH）D水平、LMR低于对照组，差异有统计学意义（P<0.05）。死亡组序贯器官衰竭（SOFA）评分、D-D水平、IL-6水平高于存活组，25（OH）D水平、LMR低于存活组，差异有统计学意义（P<0.05）。较高的SOFA评分、D-D水平、IL-6水平是脓毒症患者发生死亡的危险因素，较高的25（OH）D水平、LMR是脓毒症患者存活的保护因素（P<0.05）。D-D、25（OH）D、LMR、IL-6联合检测预测脓毒症患者发生死亡的效能［AUC（95%CI）=0.834（0.759～0.909）］优于单一指标（P<0.05），灵敏度、特异度分别为93.33%、87.50%。结论 脓毒症患者血浆D-D水平、血清IL-6水平升高，血清25（OH）D水平、LMR降低，四项指标联合可有效预测患者预后。 |
| 关键词: 脓毒症 D-二聚体 25-羟基维生素D 免疫细胞 白细胞介素-6 |
| DOI：10.3969/j.issn.1674-3806.2026.01.07 |
| 分类号:R 446 |
| 基金项目:国家自然科学基金项目（编号：82372170） |
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| Levels and clinical significance of D-D, 25(OH)D, LMR and IL-6 in patients with sepsis |
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YANG Wei1, LIU Shuangqing2, ZHANG Ling1, FANG Weihua1, YU Shengyang1, XIE Tao1, HUANG Qiuli1, LIU Xiaoyi1
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1.Department of Laboratory Medicine, the 73th Group Military Hospital of People′s Liberation Army, Xiamen 361000, China; 2.Department of Emergency, the Fourth Medical Center, Chinese PLA General Hospital, Beijing 100010, China
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| Abstract: |
| ［Abstract］ Objective To analyze the levels and clinical significance of D-dimer(D-D), 25-hydroxyvitamin D［25(OH)D］, lymphocyte-to-monocyte ratio(LMR) and interleukin-6(IL-6) in patients with sepsis. Methods Fifty-five patients with sepsis who were admitted to the 73th Group Military Hospital of People′s Liberation Army from June 2022 to June 2024 were selected as observation group. Other 50 healthy individuals who underwent physical examination during the same period were selected as control group. The levels of plasma D-D, serum 25(OH)D and serum IL-6 were detected for the patients at admission or for the control group during physical examination and LMR was calculated. According to the survival status of the patients within 3 months after admission, they were divided into death group(15 patients) and survival group(40 patients). Multivariate logistic regression was used to analyze the factors influencing the occurrence of death in the sepsis patients. The efficacy of D-D, 25(OH)D, LMR and IL-6 for predicting mortality in the sepsis patients was analyzed by using receiver operating characteristic(ROC) curve. Results The D-D and IL-6 levels in the observation group were higher than those in the control group, while the 25(OH)D level and LMR in the observation group were lower than those in the control group, with statistically significant differences between the two groups(P<0.05). The Sequential Organ Failure Assessment(SOFA) scores, D-D level and IL-6 level in the death group were higher than those in the survival group, while the 25(OH)D level and LMR in the death group were lower than those in the survival group, with statistically significant differences between the two groups(P<0.05). Higher SOFA scores, D-D level and IL-6 level were risk factors for death in the sepsis patients, while higher 25(OH)D level and LMR were protective factors for survival in the sepsis patients(P<0.05). The efficacy of the combined detection of D-D, 25(OH)D, LMR and IL-6 for predicting mortality in the sepsis patients［AUC(95%CI)=0.834(0.759-0.909)］ was superior to that of the detection of a single indicator(P<0.05), and the sensitivity and specificity were 93.33% and 87.50%, respectively. Conclusion The levels of plasma D-D and serum IL-6 in sepsis patients increase, while the levels of serum 25(OH)D and LMR in them decrease. The combined detection of these four indicators can effectively predict the prognosis of the sepsis patients. |
| Key words: Sepsis D-dimer(D-D) 25-Hydroxyvitamin D［25(OH)D］ Immune cells Interleukin-6(IL-6) |
