关键词: 炎症因子； 动态变化； 腹部外伤； 脓毒症

Abstract: Objective To analyze the predictive value of dynamic changes of multiple inflammatory factors in early screening of sepsis risk in patients with abdominal trauma.Methods A total of 360 patients with abdominal trauma admitted to the Department of Surgery of Jiangsu Provincial Corps Hospital of the Chinese People’s Armed Police Force from January 2018 to January 2022 were studied.Patients were divided into sepsis group and control group according to whether sepsis occurred.The general data and dynamic changes of inflammatory indicators were compared between the two groups.Multivariate Logistic regression was used to analyze the related factors of sepsis in patients with abdominal trauma,and ROC curve was used to analyze the value of dynamic changes of multiple inflammatory factors in predicting sepsis in patients with abdominal trauma.Results Among the patients included in the study,13 cases fell out,leaving 347 cases,of which 51 patients with sepsis were classified as sepsis group,and the remaining 296 cases were classified as control group.The incidence of sepsis was 14.70%.There was no significant difference in age,blood glucose and white blood cell at admission between the two groups(P>0.05).But the SOFA score in sepsis group(1.86±0.45) was higher than that in control group(1.54±0.36).In sepsis group, the difference of C-reactive protein (CRP) was (5.67±1.17)mg/L, the PCT was (0.12±0.05)ng/ml, the PCT variation rate was (36.43±8.02)%, and the difference of serum amylase A protein (SAA) was (8.62±1.05)m g/L,the difference of neutrophil percentage was (9.31±1.09)%, which was higher than that of control group[(4.79±0.63) mg/L,(0.10±0.04) ng/ml,(28.04±6.21)%,(7.11±0.84) mg/L,(8.41±0.92)%],the difference was statistically significant (P<0.05).Multivariate Logistic regression analysis showed that:SOFA score(OR=1.648),CRP change difference(OR=2.338),PCT variation rate(OR=1.096),SAA change difference(OR=6.043),neutrophil percentage change difference(OR=3.355) were independent risk factors for sepsis in patients with abdominal trauma.ROC curve showed that SAA difference was more effective in predicting the risk of sepsis in patients with abdominal trauma than CRP difference,PCT variation rate,neutrophil percentage change difference and SOFA score.Conclusion Dynamic analysis of multiple inflammatory factors is valuable for early screening of sepsis risk in patients with abdominal trauma,and monitoring the changes of inflammatory factors is helpful for early adjustment of treatment.

Key words: inflammatory cytokines; dynamic change; abdominal trauma; sepsis