| ObjectiveTo observe the changes of serum lipid levels in patients with sepsis and to study the clinical value of blood lipid levels in assessing the prognosis of septic patients.MethodsThe data of gender,age,body mass index(BMI)were collected from 122 septic patients from January,2014 to January,2017.At 24 hours,3 days and 7 days after the hospitalization,the levels of total cholesterol(TC),triglyceride(TG),high density lipids(TG),triglyceride(HDL-C),low-density lipoprotein(LDL-C),red blood cell distribution width(RDW),albumin(ALB),D-Dimer(D-D)and so on were determined.The acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and Sequential failure assessment(SOFA)were performed at the same day.According to the outcome,the patients were divided into survival group(discharge within 28 days,n=72)and death group(28 days without discharge or died during hospitalization,n=50).Compare the two groups to determine the prognostic values of the test results for patients with sepsis.ResultsThere was no significant difference in age,sex and BMI between the survival group and the death group(P>0.05).There were significant changes in blood lipid levels,inflammatory factors,oxidative stress factors and prognostic scores of septic patients during hospitalization(P <0.05).The levels of TC,HDL-C,LDL-C,APO A1,APO C1,APO E,TNF-α,SOD and ALB in survival group were significantly higher than death group(P<0.05),and the levels of TG,MDA,hs-CRP,D-D,RDW,APACHEⅡ score and SOFA score in survival group were significantly lower than death group(P<0.05).HDL-C level,APACHEⅡ and SOFA scores were the prognostic factors of sepsis(P<0.05).HDL-C was a protective factor for the prognosis of sepsis,however APACHEⅡ and SOFA scores were risk factors.For the prognosis prediction of septic patients,the sensitivity and specificity of HDL-C level were 41.07% and 94.47%,and the area under ROC curve(AUC)was ? ? 0.768.APACHE Ⅱ score had a sensitivity of 89.28% and specificity of96.14%,and AUC was ? ? 0.931.The sensitivity and specificity of SOFA score in the prognosis prediction of sepsis were 85.71% and 97.24% respectively,and AUC was 0.921.Conclusions1.There were significant changes in blood lipid levels,inflammatory factors,oxidative stress factors and prognostic scores of sepsis patients during hospitalization.2.The levels of TC、HDL-C、LDL-C、APO A1、APO C1、APO E、TNF-α、SOD and ALB in survival group were significantly higher than death group(P<0.05).The levels of MDA、hs-CRP、D-D、RDW、APACHEⅡ and SOFA scores in survival group were significantly lower than death group.There was no significant difference between two groups in TG level.3.The level of HDL-C,APACHEⅡ and SOFA scores within 24 hours after the hospitalization were the prognostic factors of sepsis.APACHEⅡ and SOFA scores had higher sensitivity and specificity for the prognosis prediction of septic patients.4.Low levels of HDL-C in sepsis patients and high APACHE Ⅱ and SOFA scores,suggested more critically ill and poorer prognosis. |
