The prognostic value of serum sFasL and s-Met levels in patients with sepsis secondary to pneumonia

doi:10.11958/20230029

Abstract

Abstract:

Objective To investigate the prognostic value of serum soluble Fas ligand (sFasL) and soluble interstitial epidermal transforming factor (s-Met) in patients with pneumonia and sepsis. Methods A total of 150 patients with pneumonia secondary sepsis were were divided into the survival group (96 cases) and the death group (54 cases) according to the prognosis of 28 days after admission. Seventy patients with pneumonia were selected as the pneumonia group, and 60 healthy people were selected as the control group. Serum sFasL and s-Met levels were detected by ELISA in all subjects. Spearman rank correlation analysis was used for correlation analysis of sFasL, s-Met levels and SOFA, q-SOFA scores in patients with pneumonia secondary sepsis. Multivariate Logistic regression analysis was used to analyze factors influencing the death of patients with pneumonia secondary sepsis. The diagnostic value of each index in death of patients with pneumonia secondary sepsis was analyzed by receiver characteristic operating curve. Results Levels of sFasL and s-Met increased sequentially immediately after admission in the control group, the pneumonia group and the pneumonia combined with sepsis group (P<0.05). Compared with the survival group, serum sFasL and s-Met levels were higher at 0, 24, 48, 72 and 120 h in the death group (P<0.05). Serum PCT, sFasL, s-Met and q-SOFA score were independent risk factors for death of patients with pneumonia secondary sepsis. The area under the curve of the combined detection of serum PCT, sFasL, s-Met, and q-SOFA scores for predicting mortality in patients with pneumonia secondary sepsis was 0.872 (0.838-0.909), which was higher than the single indicator detection of serum PCT, sFasL, s-Met, and q-SOFA scores of 0.778 (0.739-0.817), 0.795 (0.761-0.829), 0.712 (0.672-0.753) and 0.815 (0.774-0.857) (Z=6.450, 4.305, 5.117, 2.384, all P<0.05). Conclusion The serum sFasL and s-Met levels in patients with pneumonia secondary sepsis are serum biomarkers for evaluating the prognosis of pneumonia secondary sepsis patients.

Key words: sepsis, pneumonia, prognosis, soluble Fas ligand, soluble mesenchymal epidermal transforming factor, sequential organ failure assessment

CLC Number:

R563.1

Figures/Tables 6

References 21

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组别	n	sFasL/（ng/L）	s-Met/（mg/L）
对照组	60	10.26±2.41	0.41±0.08
肺炎组	70	16.73±3.19^a	0.89±0.12^a
肺炎继发脓毒症组	150	39.13±8.14^ab	1.79±0.39^ab
F		586.531^＊＊	547.702^＊＊

组别	n	sFasL/（ng/L）	s-Met/（mg/L）
对照组	60	10.26±2.41	0.41±0.08
肺炎组	70	16.73±3.19^a	0.89±0.12^a
肺炎继发脓毒症组	150	39.13±8.14^ab	1.79±0.39^ab
F		586.531^＊＊	547.702^＊＊

组别		n	年龄/岁		性别（男/女）		吸烟史			高血压史			糖尿病史		慢性阻塞性肺疾病病史
死亡组		54	64.25±11.09		30/24		25（46.30）			22（40.74）			16（29.63）		15（27.78）
存活组		96	63.18±10.13		56/40		50（52.08）			34（35.42）			22（22.92）		17（17.71）
t或χ²			0.600		0.109		0.463			0.419			0.823		2.088
组别	冠状动脉粥样硬化性心脏病病史					ICU住院天数/d			抗生素种类
组别	冠状动脉粥样硬化性心脏病病史					ICU住院天数/d			β-内酰胺类			碳青霉烯类				利奈唑胺		氟喹诺酮类
死亡组	13（24.07）					11（7，16）			11（20.37）			13（24.07）				15（27.78）		15（27.78）
存活组	16（16.67）					14（10，22）			23（23.96）			25（26.04）				20（20.83）		28（29.17）
t或χ²	1.216					2.147			0.987
组别	抗生素使用时间/d			WBC/（×10⁹/L）				PCT/（μg/L）			CRP/（mg/L）			SOFA/分			q-SOFA/分
死亡组	12.09±2.74			13.84（7.84，18.29）				0.97±0.31			122.05±28.29			9.59±2.28			2.31±0.47
存活组	11.45±2.15			11.64（7.18，16.79）				0.81±0.20			116.48±21.25			4.30±1.67			1.18±0.36
t或χ²	1.582			0.647				3.837^＊＊			1.364			16.274^＊＊			16.490^＊＊

组别		n	年龄/岁		性别（男/女）		吸烟史			高血压史			糖尿病史		慢性阻塞性肺疾病病史
死亡组		54	64.25±11.09		30/24		25（46.30）			22（40.74）			16（29.63）		15（27.78）
存活组		96	63.18±10.13		56/40		50（52.08）			34（35.42）			22（22.92）		17（17.71）
t或χ²			0.600		0.109		0.463			0.419			0.823		2.088
组别	冠状动脉粥样硬化性心脏病病史					ICU住院天数/d			抗生素种类
组别	冠状动脉粥样硬化性心脏病病史					ICU住院天数/d			β-内酰胺类			碳青霉烯类				利奈唑胺		氟喹诺酮类
死亡组	13（24.07）					11（7，16）			11（20.37）			13（24.07）				15（27.78）		15（27.78）
存活组	16（16.67）					14（10，22）			23（23.96）			25（26.04）				20（20.83）		28（29.17）
t或χ²	1.216					2.147			0.987
组别	抗生素使用时间/d			WBC/（×10⁹/L）				PCT/（μg/L）			CRP/（mg/L）			SOFA/分			q-SOFA/分
死亡组	12.09±2.74			13.84（7.84，18.29）				0.97±0.31			122.05±28.29			9.59±2.28			2.31±0.47
存活组	11.45±2.15			11.64（7.18，16.79）				0.81±0.20			116.48±21.25			4.30±1.67			1.18±0.36
t或χ²	1.582			0.647				3.837^＊＊			1.364			16.274^＊＊			16.490^＊＊

组别	n		sFasL/（ng/L）										F
组别	n		0 h		24 h		48 h		72 h		120 h		F
存活组	96		32.15±6.55		32.46±6.70		33.11±6.14		33.25±6.55		32.69±6.30		0.480
死亡组	54		51.54±10.46		53.17±11.25		54.64±11.70		57.94±10.46		63.18±13.45		8.654^＊＊
t			13.955^＊＊		14.140^＊＊		14.379^＊＊		17.770^＊＊		18.857^＊＊
组别		s-Met/（mg/L）										F
组别		0 h		24 h		48 h		72 h		120 h		F
存活组		1.71±0.38		1.72±0.39		1.74±0.38		1.78±0.35		1.77±0.36		0.644
死亡组		1.93±0.41		1.98±0.42		2.13±0.45		2.26±0.48		2.63±0.51		20.411^＊＊
t		3.308^＊＊		3.812^＊＊		5.641^＊＊		7.030^＊＊		12.040^＊＊