| 血清维生素在脓毒症预测模型中的构建与验证 |
| 投稿时间：2025-07-02 修订日期：2025-08-07 点此下载全文 |
| 引用本文：史洪伟,王英臣,张竞涛,孙立群.血清维生素在脓毒症预测模型中的构建与验证[J].医学研究杂志,2025,54(12):99-105 |
| DOI：
10.11969/j.issn.1673-548X.2025.12.017 |
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| 基金项目:江苏省卫生健康委科研项目(M2020045)；789人才项目(789ZYRC202070317) |
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| 中文摘要:目的 探讨血清维生素水平在脓毒症预测中的价值。方法 采用前瞻性研究方法,选取2023年8月～2024年12月南京医科大学第二附属医院急诊科或重症医学科收治的129例重症患者,其中脓毒症患者78例,非脓毒症危重患者51例。采用液相色谱-串联质谱法测定10种血清维生素水平,并进行组间比较、相关性分析、多因素Logistic回归分析和受试者工作特征(receiver operating characteristic, ROC)曲线分析,并构建临床预测模型。结果 脓毒症患者血清中25-羟基维生素D3、25-羟基维生素(D2+D3)、维生素A、维生素E、维生素B9水平均显著降低(P<0.05)。多因素Logistic回归分析结果表明,较低的维生素B9水平为脓毒症发生的独立危险因素。基于维生素B9、急性生理学与慢性健康状况评估Ⅱ(acute physiology and chronic health evaluation Ⅱ, APACHE Ⅱ)评分、序贯器官衰竭评估(sequential organ failure assessment, SOFA)评分、降钙素原(procalcitonin, PCT)、C反应蛋白(C-reactive protein, CRP)构建的预测模型具有良好效能。结论 基于维生素B9及传统临床指标构建的预测模型,可实现对脓毒症发生风险的早期识别与分层管理,具有较高的临床应用价值。 |
| 中文关键词:脓毒症 感染性休克 重症感染 维生素 预测模型 |
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| Construction and Validation of Serum Vitamins in Sepsis Prediction Models. |
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| Abstract:Objective To explore the value of serum vitamin levels in predicting sepsis. Methods A total of 129 critically ill patients admitted to the Department of Emergency or Intensive Care Unit, the Second Affiliated Hospital of Nanjing Medical University from August 2023 to December 2024 were prospectively selected, including 78 patients with sepsis and 51 patients without sepsis. The levels of 10serum vitamins were measured using liquid chromatography-tandem mass spectrometry. Between-group comparisons, correlation analysis, multivariate Logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were conducted, and a clinical prediction model was constructed. Results The serum levels of 25-hydroxyvitamin D3,25-hydroxyvitamin (D2+D3), vitamin A, vitamin E, and vitamin B9 were significantly decreased in patients with sepsis (P<0.05). The results of multivariate Logistic regression analysis indicated that a lower level of vitamin B9 was an independent risk factor for the occurrence of sepsis. The prediction model based on vitamin B9, acute physiology and chronic health evaluationⅡ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, procalcitonin (PCT) and C-reactive protein (CRP) demonstrated good efficacy. Conclusion The predictive model based on vitamin B9 and conventional clinical indicators can achieve early identification and stratified management of the risk of sepsis occurrence, demonstrating considerable clinical application value. |
| keywords:Sepsis Septic shock Severe infection Vitamins Predictive model |
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