[1]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,(5):617-622.[doi:DOI:10.3969/j.issn.1000-7377.2026.05.007]
　ZHANG Suting,XU Yinyin.Relationship between serum ESM-1,sTM,sE-selectin and prognosis in patients with Gram-negative bacteria bloodstream infection[J].,2026,(5):617-622.[doi:DOI:10.3969/j.issn.1000-7377.2026.05.007]
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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

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年5期
页码:
617-622
栏目:
临床研究
出版日期:
2026-05-05

文章信息/Info

Title:
Relationship between serum ESM-1,sTM,sE-selectin and prognosis in patients with Gram-negative bacteria bloodstream infection
作者:
张素婷; 许银银
（重庆医科大学附属永川医院检验科，重庆 402160）
Author(s):
ZHANG Suting; XU Yinyin
（Department of Clinical Laboratory,the Affiliated Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China）
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
Keywords:
Bloodstream infection; Gram-negative bacteria; Endothelial cell-specific molecule 1; Soluble thrombomodulin; Soluble E-selectin; Prognosis
分类号:
R631
DOI:
DOI:10.3969/j.issn.1000-7377.2026.05.007
文献标志码:
A
摘要:
目的：探讨血清内皮细胞特异性分子-1（ESM-1）、可溶性血栓调节蛋白（sTM）、可溶性E-选择素（sE-selectin）与革兰阴性菌血流感染患者预后的关系。方法：选取193例革兰阴性菌血流感染患者，检测血清ESM-1、sTM及sE-selectin水平。统计28 d内患者存活情况，并分为死亡组和存活组。采用多因素Logistic回归分析革兰阴性菌血流感染患者预后的影响因素，受试者工作特征（ROC）曲线分析血清ESM-1、sTM、sE-selectin对革兰阴性菌血流感染患者预后的预测价值，决策曲线分析（DCA）验证联合预测的临床实用性。结果：随访193例患者中，死亡52例，存活141例。死亡组血清ESM-1、sTM及sE-selectin水平高于存活组（均P＜0.05）。死亡组患者基线急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）、感染性休克比例、使用血管活性药物比例及C-反应蛋白（CRP）、降钙素原（PCT）水平高于存活组，基线收缩压低于存活组（均P＜0.05）。高基线APACHEⅡ评分、发生感染性休克及高血清ESM-1、sTM、sE-selectin水平是革兰阴性菌血流感染患者预后的独立危险因素（均P＜0.05）。血清ESM-1、sTM、sE-selectin预测革兰阴性菌血流感染患者预后不良的曲线下面积（AUC）分别为0.712、0.709、0.712，三者联合预测的AUC为0.847，高于单独预测的AUC（均P＜0.05）。DCA曲线显示，当风险阈值为0.05～0.55时，联合预测的净获益率优于单独预测。结论：血清ESM-1、sTM、sE-selectin是革兰阴性菌血流感染患者预后的影响因素，三者联合检测对患者预后具有较好的预测价值。
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 bacterial 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 APACHEⅡ score,proportion of septic shock,proportion 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 APACHEⅡ 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 predictive value for the prognosis of these patients.

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备注/Memo

备注/Memo:
国家自然科学基金资助项目（82200218）
更新日期/Last Update: 2026-05-05