Study On The Correlation Between The Expression Levels Of PCT,HBP And STREM-1 And The Species And Prognosis Of Pathogenic Bacteria In Abdominal Infection

Objective:To comprehensively analyze the expression levels of proneneneba procalcitonin（PCT）,heparin binding protein（HBP）and soluble triggering receptor expressed on Myeloid Cells-1（s TREM-1）in abdominal infection,and to study the correlation between them and pathogenic bacteria,disease severity and prognosis.Method:A prospective study was conducted to collect patients with abdominal infection from the Department of General Surgery and Critical Care Medicine of Baotou Central Hospital from November 2021 to November 2022 based on inclusion and exclusion criteria;According to the specific condition of the enrolled cases,blood or body fluid culture should be improved as soon as possible.Calculate the Acute Physiology and Chronic Health Evaluation II（APACHE II）score based on the worst difference in laboratory indicators on the first day of enrollment,and classify patients with abdominal infection into mild to moderate abdominal infection group and severe abdominal infection group according to the recommended severity grading of abdominal infection in the Chinese Guidelines for the Diagnosis and Treatment of Abdominal Infection（2019 version）.5ml of peripheral venous blood of the enrolled patients on the first,third and seventh days were collected,and the serum was separated after centrifugation,and the levels of serum PCT,HBP and s TREM-1 were detected.According to the results of blood or body fluid culture,pathogenic bacteria are divided into Gram positive bacteria（G⁺bacteria）,Gram negative bacteria（G^-bacteria）,fungi,mixed infection bacteria,and negative culture groups.Observe the changes in the levels of PCT,HBP,and s TREM-1 in patients with mild to moderate and severe abdominal infections before and after treatment,analyze their value in the severity and prognosis of abdominal infections,and then analyze their correlation with the types of pathogens based on the serum levels of PCT,HBP,and s TREM-1 before the sampling time of positive patient culture.Result:（1）A total of 93 strains of pathogenic bacteria were cultured in 81 patients with abdominal infection,including 34 strains of G⁺bacteria（36.56%）,53 strains of G^-bacteria（56.99%）,and 6 strains of fungi（6.45%）;Some patients have multiple pathogen infections;There were 16 cases of negative culture,accounting for 19.75%.（2）The levels of PCT and HBP were statistically significant at the same time point between the mild to moderate group and the severe group（P<0.05）,while the levels of PCT and HBP in the severe group were significantly higher than those in the mild to moderate group at the same time point.Time trend:The levels of PCT and HBP showed statistically significant changes over time between the two groups（P<0.05）;The levels of PCT and HBP in the mild to moderate and severe groups were significantly lower at D₃time point than at D₁time point,and significantly lower at D₇time point than at D₃time point;There was no statistically significant difference in the level of s TREM-1 between the two groups at D₁and D₃time points（P>0.05）;There was statistical significance（P<0.05）in the comparison of D₇time points between the two groups.Time trend:The s TREM-1 level showed a statistically significant trend over time between the two groups（P<0.05）.（3）The value of serum levels of PCT,HBP,and s TREM-1,as well as their combined detection,in early prediction of the severity of abdominal infection in patients:the AUC（0.94）detected by the combination of three inflammatory indicators is the highest,followed by the AUC of PCT（0.91）and HBP（0.75）,while the AUC of s TREM-1（0.58）is relatively low.（4）The levels of PCT,HBP,and s TREM-1 were significantly higher in G^-bacterial infections than in G⁺bacteria（P<0.05）;The levels of PCT and s TREM-1 in G^-bacteria infection were significantly higher than those in G⁺bacteria and fungi（P<0.05）;（5）The predictive value of serum PCT,HBP,s TREM-1 levels,and combined detection levels for G^-bacteria:The AUC（0.88）of the three serum inflammatory indicators detected in combination was the highest,followed by the AUC of PCT（0.86）and s TREM-1（0.72）,while the AUC of HBP（0.63）was relatively low.Conclusion:（1）The combined determination of serum PCT,HBP,and s TREM-1 levels in patients with abdominal infection has predictive significance for determining the severity of the condition,and can help physicians quickly determine the severity of the condition in clinical practice.（2）The types of pathogenic bacteria in abdominal cavity infection are correlated with serum levels of PCT,HBP,and s TREM-1.The levels of PCT,HBP,and s TREM-1 in serum of G^-bacteria infection are significantly higher than those of G⁺bacteria and fungi;The combined determination of serum PCT,HBP,and s TREM-1 levels has certain clinical guiding significance in distinguishing G^-bacterial infections.