Research of the Value of Dynamic Monitoring of Blood Lipid Levels in Septic Shock for Predicting Short-Term Prognosis
10.3969/j.issn.1671-7414.2024.04.013
- VernacularTitle:脓毒症休克患者血脂水平动态监测对预测短期预后的价值研究
- Author:
Shiyue ZHANG
1
;
Qing ZHANG
;
Chunlai LIU
;
Xing QI
Author Information
1. 北京通州区中西医结合医院,北京 101199
- Keywords:
septic shock;
cholesterol;
high density lipoprotein cholesterol
- From:
Journal of Modern Laboratory Medicine
2024;39(4):72-75
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictive value of blood lipid dynamics of septic shock for the short-term prognosis.Methods A total of 107 patients with septic shock treated in Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine from March 2019 to July 2023 were selected as the study subjects.They were divided into survival group(n=76)and death group(n=31)based on their 28-day outcomes.Total cholesterol(TC),triacylglycerol(TG),high density lipoprotein cholesterol(HDL-C)and LDL cholesterol(LDL-C)concentrations were tested at disease onset(day 0),day 4±1 and day 7±1.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of lipid dynamics on outcomes in patients with septic shock.Multivariate COX regression analysis was used to analyze factors affecting the prognosis of patients with septic shock.Result The levels of TC and HDL-C at disease onset,as well as TC,HDL-C and LDL-C on day(4±1)and day(7±1)in the survival group were higher than those in death group,and the differences were significant(Z=2.241～5.744,all P＜0.05).The areas under the curve[AUC(95％)]for the prediction of changes in HDL-C and LDL-C in the first week of admission were 0.775(95％CI:0.685～0.850)and 0.646(95％CI:0.547～0.736),with the best cutoff values of 0.16mmol/L and 0.28mmol/L,sensitivity of 70.97％and 64.52％,and specificity of 82.89％and 69.74％,respectively.Multivariate regression analysis showed that HDL-C dynamics was independently associated with poor prognosis(OR=0.141,95％CI:0.044～0.454,P=0.001).Conclusion Monitoring the dynamic changes of blood lipid at the first week of admission could help in predicting short-term outcomes in patients with septic shock.
