Page 30 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第43卷第9期
·1208 · Journal of Nanjing Medical University（Natural Sciences） 2023年9月

·临床研究·

老年脓毒症患者早期炎症因子水平及预后的相关性分析

甘宇婧，史如鹏，吴丹瑛，黄 敏 *
南京医科大学第一附属医院老年重症监护室，江苏 南京 210029

［摘 要］ 目的：分析老年脓毒症患者早期炎症因子指标改变与病情严重程度及预后的相关性。方法：回顾性分析南京医科
大学第一附属医院2020年9月—2022年3月入住老年重症监护病房的135例脓毒症患者的临床资料，根据年龄将患者分为老
年组（≥65岁）和青壮年组（＜65岁）。对其中年龄≥65岁的老年脓毒症患者，根据是否为脓毒症休克分为脓毒症休克组与脓毒
症组，根据28 d病死率分为存活组及死亡组。分别比较以上各分组间的炎症因子指标；用Spearman相关分析法分析老年脓毒
症患者白细胞计数（white blood cell，WBC）、降钙素原（procalcitonin，PCT）、C 反应蛋白（C⁃reactive protein，CRP）、白介素（inter⁃
leukin，IL）⁃2、IL⁃4、IL⁃6、IL⁃10、肿瘤坏死因子（tumor necrosis factor，TNF）⁃α、干扰素（interferon，IFN）⁃γ、血小板（platelet，PLT）、淋
巴细胞（lymphocyte，Lym）与APACHE Ⅱ评分的相关性；绘制受试者工作特征（receiver operating characteristic，ROC）曲线比较以
上各指标对老年脓毒症患者28 d病死率的预测能力。结果：脓毒症患者中，老年组PLT、Lym显著低于青壮年组，APACHE Ⅱ
评分显著高于青壮年组。老年脓毒症患者中，脓毒症休克组PCT、CRP、APACHE Ⅱ评分显著高于脓毒症组，PLT显著低于脓
毒症组；存活组APACHE Ⅱ评分显著低于死亡组。老年脓毒症患者IL⁃10与APACHE Ⅱ评分呈正相关，PLT与APACHE Ⅱ评
分呈负相关；根据ROC曲线及曲线下面积，APACHE Ⅱ评分、排除或不排除APACHE Ⅱ的所有指标联合均能预测老年脓毒症
患者28 d病死率。结论：在老年脓毒症患者中，早期血浆PLT越低、IL⁃10越高，患者病情越重，预后越差；多种指标联合预测老
年脓毒症患者28 d病死率的准确率更高。
［关键词］ 炎症因子；脓毒症；血小板；白介素⁃10
［中图分类号］ R631.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）09⁃1208⁃08
doi：10.7655/NYDXBNS20230904

Correlation analysis between early inflammatory factors and the prognosis in elderly
patients with sepsis
GAN Yujing，SHI Rupeng，WU Danying，HUANG Min *
Department of Geriatric ICU，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：The current study aims to analyse the correlation between early inflammatory factor changes and severity as
well as prognosis in elderly patients with sepsis. Methods：Retrospective analysis of the clinical data of 135 sepsis patients admitted to
the First Affiliated Hospital of Nanjing Medical University between September 2020 and March 2022. According to age，patients were
divided into the elderly group（≥ 65 years old）and the young adult group（<65 years old）. The elderly patients（≥ 65 years old）with
sepsis were divided into septic shock group and septic group according to whether they had septic shock，and divided into survival
group and death group according to the 28⁃day mortality rate. The inflammatory factor changes were compared between the above sub⁃
groups. The correlations between white blood cell（WBC），procalcitonin（PCT），C⁃reactive protein（CRP），interleukin（IL）⁃2，IL⁃4，IL⁃6，
IL⁃10，tumor necrosis factor（TNF）⁃α，interferon（IFN）⁃γ，platelet（PLT），lymphocyte（Lym）and APACHE Ⅱ score in elderly patients
with sepsis were analyzed by Spearman correlation analysis. ROC curve was used to compare above ⁃ mentioned indexes in the
judgement of 28⁃day mortality rate in elderly patients with sepsis. Results：In patients with sepsis，the PLT and Lym in the elderly
group were significantly lower than those in the young adult group，and APACHE Ⅱ score in the elderly group was significantly higher
than that in the young adult group. In elderly patients with sepsis，the PCT，CRP，APACHE Ⅱ score in septic shock group were
significantly higher than those in the septic group，and PLT in septic shock group was significantly lower than that in the septic group；

［基金项目］ 江苏省卫生健康委员会江苏省干部保健科研课题（BJ20019）
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通信作者（Corresponding author），E⁃mail：hmdoctor@163.com