陕西医学杂志2026，Vol.55Issue(5)：617-622,6.DOI:10.3969/j.issn.1000-7377.2026.05.007
血清ESM-1、sTM、sE-selectin与革兰阴性菌血流感染患者预后关系研究
Relationship between serum ESM-1,sTM,sE-selectin and prognosis in patients with Gram-negative bacteria bloodstream infection
摘要
Abstract
Objective:To investigate the relationship between serum endothelial cell-specific molecule 1(ESM-1),soluble thrombomodulin(sTM),soluble E-selectin(sE-selectin)and prognosis in patients with Gram-negative bacte-rial bloodstream infection.Methods:A total of 193 patients with Gram-negative bacterial bloodstream infection were enrolled,and serum levels of ESM-1,sTM and sE-selectin were detected.The 28-day survival status of patients was recorded,and they were divided into a death group and a survival group.Multivariate logistic regression analysis was used to analyze the prognostic factors in patients with Gram-negative bacterial bloodstream infection.ROC curve was applied to evaluate the predictive value of serum ESM-1,sTM and sE-selectin for prognosis of these patients.DCA was performed to verify the clinical utility of combined prediction.Results:Among the 193 followed-up patients,52 died and 141 survived.Serum levels of ESM-1,sTM and sE-selectin in the death group were significantly higher than those in the survival group(all P＜0.05).The baseline APACHE Ⅱ score,proportion of septic shock,propor-tion of vasoactive drug use,and levels of C-reactive protein(CRP)and procalcitonin(PCT)in the death group were higher than those in the survival group,while baseline systolic blood pressure was lower(all P＜0.05).High baseline APACHE Ⅱ score,septic shock,and high serum levels of ESM-1,sTM and sE-selectin were independent risk factors for prognosis in patients with Gram-negative bacterial bloodstream infection(all P＜0.05).The AUC of serum ESM-1,sTM and sE-selectin in predicting poor prognosis was 0.712,0.709 and 0.712,respectively,and the AUC of the combined prediction was 0.847,which was higher than that of single indicator(all P＜0.05).DCA showed that the net benefit rate of combined prediction was better than that of single prediction when the risk threshold ranged from 0.05 to 0.55.Conclusion:Serum ESM-1,sTM and sE-selectin are influencing factors for prognosis in patients with Gram-negative bacterial bloodstream infection,and combined detection of the three indicators has favorable pre-dictive value for the prognosis of these patients.关键词
血流感染/革兰阴性菌/内皮细胞特异性分子-1/可溶性血栓调节蛋白/可溶性E-选择素/预后Key words
Bloodstream infection/Gram-negative bacteria/Endothelial cell-specific molecule 1/Soluble throm-bomodulin/Soluble E-selectin/Prognosis分类
医药卫生引用本文复制引用
张素婷,许银银..血清ESM-1、sTM、sE-selectin与革兰阴性菌血流感染患者预后关系研究[J].陕西医学杂志,2026,55(5):617-622,6.基金项目
国家自然科学基金资助项目(82200218) （82200218）
