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《Chinese Journal of Critical Care Medicine》 2019-03
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Risk factors analysis of sepsis in burn patients and predictive value of serum lipeprotein related phosphatase A2,lipid peroxide

Gao Ying;Li Bao;Gao Hong-hong;Department of Burn and Plastic Surgery,The People's Hospital of Cangzhou;  
Objective To investigate the risk factors of patients with burn sepsis, and the study clinical significance of lipoprotein related phosphatase A2( Lp-PLA2) and lipid peroxide( LPO) on the prognosis of patients with bum sepsis. Methods From January 2013 to December 2016, 163 cases of burn patients were selected as case group which were prospectively studied. According to the diagnostic criteria of sepsis, the patients were divided into sepsis group(51 cases) and non-sepsis group(112 cases). The patients with sepsis were divided into survival group( 33 cases) and death group(18 cases) according to the prognosis. At the same time, the healthy population of the hospital was selected as the control group(80 cases). Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of sepsis in bum patients. The serum levels of Lp-PLA2 and LPO were measured at the time of admission, and the role of Lp-PLA2 and LPO in the prognosis evaluation of patients with burn sepsis were evaluated by the subjects' working characteristic curve(ROC) and the area under the curve( AUC). Results The total area of body surface( TABS)( OR = 1.72,95% CI1.15 ~2.54), Ⅲ degree burn area(OR = 2. 46,95% CI 1. 65 ~3. 42), admission time( OR = 1. 18,95% CI1. 16 ~ 1.22) and inhalation injury( OR=6.79,95% CI2. 30-11.36) were the risk factors of burn combined with sepsis. The level of Lp — PLA2 and LPO in the(289.5 ±50.7)ng/mL、[8.1(6.7,16. 6) ]nmol/mL were higher than those of the(123.8 ±39. 6)ng/mL、[5.2(4.7,6. 0) ] nmol/mL(P 0.05), and the level of Lp-PLA2 and LPO in the patients with(353.1 ± 66.5) ng/mL、[13. 8(9.2,19.6) ]nmol/mL were higher than those of the(266. 3 ± 45. 6) ng/mL、[7. 4(5. 9,14. 2) ] nmol/mL(P 0. 05),but the level of Lp-PLA2 and LPO in the(336. 7 ±61.4)ng/mL、[ 10.9(7.1,16. 3)]nmol/mL were lower than those of the death( 380. 9 ± 70. 2) ng/mL、[ 15. 7(9. 8,22. 1) ] nmol/mL group(P 0. 05). Through the ROC curve analysis, the AUC Lp-PLA2, LPO and Lp-PLA2 combined with LPO in predicting the prognosis of patients with burn sepsis were 0. 820, 0.689, 0. 872 respectively, and the sensitivity were 0.778,0. 833,0. 833 respectively, and the specificity was 0.758,0.545 and 0. 818, respectively. Conclusion The TBAS, III degree bum area, admission time and inhalation injury are the risk factors of burn complicated with sepsis. Lp-PLA2 and LPO have certain value in predicting the prognosis of burn sepsis, but the combination detection of them is better than single detection.
【Fund】: 沧州市科学技术研究与发展指导计划项目(172302157)
【CateGory Index】: R644
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