Application Value Of Heparin-binding Protein In Early Diagnosis And Evaluation Of Sepsis

Objective:The purpose of this study is to explore the role of HBP in early diagnosis of sepsis and septic shock,and compare it with PCT,CRP,WBC,Lac and other traditional inflammatory indexes,so as to provide basis for early diagnosis and disease evaluation.Methods:A total of 107 patients older than 18 years admitted to the ICU of the First Hospital of Jilin University on May 1,2021 and January 1,2022 were selected and divided into three groups according to whether they developed sepsis and whether they had shock: non-sepsis group（n = 39）,septic non-shock group（n = 31）and septic shock group（n = 37）.The levels of HBP,WBC,PCT,CRP and Lac within 24 hours after admission were collected.The value of the above indicators in the early prediction of sepsis was analyzed by multivariate logistic regression analysis and receiver operating characteristic curve（ROC）,and the correlation between HBP and PCT,CRP,WBC,Lac,SOFA score,APACHE II score,and the number of injured organs was explored.Result:（1）A total of 107 patients were included in this study,including 63 males and 44 females,aged 26 to 80 years.There were 39 patients in the non-sepsis group,31 patients in the sepsis non-shock group,and 37 patients in the septic shock group.Underlying diseases include hypertension,diabetes,coronary heart disease,chronic obstructive pulmonary disease and other respiratory diseases.There were no statistically significant differences in age,gender,and past history among the three groups（P > 0.05）.（2）The HBP levels of the three groups were: 9.40（5.10,23.30）,61.70（35.80,85.20）,and95.60（54.01,209.75）ng/m L,respectively,and there were significant differences between the two groups（P < 0.05）.The PCT levels of the three groups of patients were: 0.51（0.07,4.12）,2.94（0.94,10.34）,and 16.81（5.89,65.29）ng/m L,respectively,and the PCT levels of the patients with sepsis and associated shock were significantly higher than those of the other two groups（P < 0.05）,while there was no statistically significant difference between these two groups（P > 0.05）.The CRP levels of the three groups were: 36.43（7.66,83.21）,162.48（61.93,313.36）,and 217.48（123.81,356.17）mg/L,respectively,and there were statistically significant differences between the non-sepsis group and the other two groups（P < 0.05）,while there was no statistically significant difference between the shock and non-shock groups in septic patients（P > 0.05）.The levels of Lac in the three groups of patients were: 1.40（0.90,2.20）,2.10（1.50,2.90）,and 2.70（1.65,5.50）mmol/L,respectively,and the Lac level in the septic shock group was significantly higher than that in the non-sepsis group（P < 0.05）,and there were no statistically significant differences between the septic shock group and the other two groups（P > 0.05）.The WBC levels of the three groups were: 8.41（5.19,12.14）,11.69（8.35,14.23）,and 15.96（9.93,20.00）× 109/L,respectively,and there were statistically significant differences between the three groups（P < 0.05）.（3）The scores of SOFA score in the three groups were 5.69 ± 2.59,7.52 ± 3.36,and 12.05± 3.82（points）,and there were statistically significant differences between the three groups（P< 0.05）.The APACHE II scores of the three groups were 12.7 ± 4.01,15.29 ± 5.76,and 18.81± 5.55（points）,respectively,and there was a statistically significant difference between each two groups（P < 0.05）.The number of injured organs in each group was 2.41 ± 1.16,3.19 ±1.35,and 4.57 ± 1.30,respectively,and there was a significant difference between the three groups（P < 0.05）.（4）Receiver operating characteristic curve（ROC）analysis of the diagnostic value of each index for sepsis showed that the area under the curve（AUC）of HBP,CRP,PCT,WBC,and Lac was: 0.922,0.809,0.688,0.670,and 0.665,respectively,and compared with other traditional inflammatory indicators,the AUC of HBP was the largest,and when the HBP cutoff value was 24 ng/m L,its sensitivity and specificity for the diagnosis of sepsis were 93.5% and82.1%,indicating the highest diagnostic value.（5）The diagnostic value of each index for septic shock in receiver operating characteristic curve（ROC）analysis,the area under the curve（AUC）of HBP,PCT,CRP,Lac,and WBC was:0.968,0.864,0.863,0.780,and 0.773,respectively.The AUC of HBP was the largest,and when the cutoff value of 35.95 ng/m L was taken for HBP,its sensitivity and specificity for the diagnosis of septic shock were 91.9% and 92.3%,indicating the highest diagnostic value.（6）Spearman correlation analysis showed that among all study subjects,HBP had a correlation with other test parameters（P < 0.05）,and had the greatest correlation with CRP and SOFA scores.There was a correlation between PCT,Lac and SOFA score,a correlation between PCT,Lac and the number of organ injuries（P < 0.05）,and no correlation between the other indicators（P > 0.05）in non-sepsis.There was a correlation between PCT,Lac and the number of organ injuries in sepsis（P < 0.05）,and there was the greatest correlation between PCT and the number of organ injuries（r = 0.423）.In septic shock,there was a correlation between Lac and HBP,SOFA score,APACHE II score,and the greatest correlation with APACHE II score（r = 0.469）;there was also a correlation between CRP and APACHE II score.Conclusion:In the diagnosis of sepsis,HBP has better diagnostic value than PCT,CRP,WBC,Lac and other infection indicators,and can be used as one of the indicators for the diagnosis of sepsis.HBP,PCT,and CRP have a good diagnostic value for septic shock,with HBP having the highest diagnostic value and can assess the severity of the patient’s condition.There was a positive correlation between HBP and PCT,CRP,Lac,WBC,APACHE II score,SOFA score,and the number of injured organs.