Study On The Correlation Between Inflammatory Factors And Nutritional Indicators In Evaluating The Severity And Prognosis Of Sepsis

Objective:Dynamic monitoring of inflammatory factors and nutritional indicators,and evaluation of the value of their combined use in the condition and prognosis of sepsis.Methods:Patients with sepsis diagnosed in the emergency ICU admitted to our hospital from March 2017 to September 2018 were selected according to the diagnostic criteria for sepsis.In accordance with the severity of infection,patients were divided into sepsis group(20 cases)and septic shock group(23 cases).A total of 22 patients with cerebrovascular disease,coronary heart disease and trauma who did not have sepsis were selected as the control group.In terms of the 28-day prognosis,the patients with confirmed sepsis were divided into survival group(26 cases)and death group(17cases).Serum CRP,PCT,IL-6,IL-8,IL-10 and other infection indicators,serum ALB,PA,TF,SF,vitamin B12,folic acid,Fe and other nutritional indicators were detected on the day of diagnosis of all patients,on the third and the seventh day of treatment,and calculate CRP/ ALB,CRP / PA.Record the corresponding time platelet,bilirubin,creatinine,blood pressure,urine output and other clinical data,assess the sequential organ failure score(SOFA)within 24 h and APACHEII score.Analyze and compare the changes of the above indicators at different time points in the sepsis group,septic shock group and non-sepsis group,and analyze the correlation between CRP/PA,CRP/ALB and other indicators and SOFA scores,the changes of indexes in the death group and the survival group were evaluated dynamically.Results:1.CRP,PCT,IL-6,IL-8,IL-10 and SF were higher in the septic shock group than in the non-sepsis group on days 1,3,and 7 after admission.ALB,PA and TF were lower than the non-sepsis group.2.CRP,PCT,IL-6,IL-8,IL-10 and SF were higher in the sepsis death group on than in the survival group on days 1,3,and 7 after admission.ALB,PA,TF,vitamin B12,folic acid and Fe were lower than the survival group.3.CRP/ALB,CRP/PA,CRP,etc.were positively correlated with SOFA score,and the correlation between CRP/ALB and SOFA scores was the highest.The correlation between CRP,PCT,IL-6,IL-8,IL-10 and other indicators and the SOFA score was lower than CRP/ALB.4.The CRP level in the death group continued to increase,and the ALB level continued to decrease,resulting in an increase in the ratio of the two,and the CRP/ALB level gradually increased with time.5.The level of CRP/ALB in the survival group gradually decreased as the treatment progressed.Conclusion:1.The inflammatory reaction of patients with sepsis is severe,and the disorder of nutrition and metabolism occurs.The inflammatory factors and nutritional indicators can reflect the severity and prognosis of the disease to some extent.2.CRP/ALB and CRP were positively correlated with SOFA score,and the correlation between CRP/ALB and SOFA score was the highest.The predictive value of CRP/ALB for assessing a patient's condition and prognosis is superior to that of a single CRP.3.As the severity of sepsis increases,CRP/ALB levels increase,suggesting that the patient's infection is uncontrolled,malnourished,and the prognosis is poor.