The predictive value of heparin-binding protein for bacterial infections in patients with severe multiple trauma

Li Li, Xiao-xi Tian, Gui-long Feng, Bing Chen
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Abstract

Abstract Introduction: Heparin-binding protein is an inflammatory factor with predictive value and participates in the inflammatory response through antibacterial effects, chemotaxis, and increased vascular permeability. The role of heparin-binding protein in sepsis has been progressively demonstrated, but few studies have been conducted in the context of multiple trauma combined with bacterial infections. This study aims to investigate the predictive value of heparin-binding protein for bacterial infections in patients with severe multiple trauma. Materials and methods: Patients with multiple trauma in the emergency intensive care unit were selected for the study, and plasma heparin-binding protein concentrations and other laboratory parameters were measured within 48 hours of admission to the hospital. A two-sample comparison and univariate logistic regression analysis were used to investigate the relationship between heparin-binding protein and bacterial infection in multiple trauma patients. A multifactor logistic regression model was constructed, and the ROC curve was plotted. Results: Ninety-seven patients with multiple-trauma were included in the study, 43 with bacterial infection and 54 without infection. According to data analysis, heparin-binding protein was higher in the infected group than in the control group [(32.00±3.20) ng/mL vs. (18.52±1.33) ng/mL]. Univariate logistic regression analysis shows that heparin-binding protein is related to bacterial infection (OR=1.10, Z=3.91, 95%CI:1.05~1.15, P=0.001). Multivariate logistic regression equations showed that patients were 1.12 times more likely to have bacterial infections for each value of heparin-binding protein increase, holding neutrophils and PCT constant. ROC analysis shows that heparin-binding protein combined with neutrophils and PCT has better predictive value for bacterial infection [AUC=0.935, 95%CI:0.870~0.977]. Conclusions: Heparin-binding protein may predict bacterial infection in patients with severe multiple trauma. Combining heparin-binding protein, PCT, and neutrophils may improve bacterial infection prediction.
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肝素结合蛋白对严重多发性创伤患者细菌感染的预测价值
摘要导言:肝素结合蛋白是一种具有预测价值的炎症因子,通过抗菌作用、趋化作用和增加血管通透性参与炎症反应。肝素结合蛋白在败血症中的作用已逐渐得到证实,但很少有研究是在多处创伤合并细菌感染的情况下进行的。本研究旨在探讨肝素结合蛋白对严重多发性创伤患者细菌感染的预测价值:选取急诊重症监护室的多发创伤患者作为研究对象,在入院 48 小时内测定血浆肝素结合蛋白浓度和其他实验室指标。采用双样本比较法和单变量逻辑回归分析法研究多发性创伤患者肝素结合蛋白与细菌感染之间的关系。建立了多因素逻辑回归模型,并绘制了ROC曲线:研究共纳入 97 例多发性创伤患者,其中 43 例有细菌感染,54 例无感染。数据分析显示,感染组的肝素结合蛋白高于对照组[(32.00±3.20)纳克/毫升 vs. (18.52±1.33)纳克/毫升]。单变量逻辑回归分析显示,肝素结合蛋白与细菌感染有关(OR=1.10,Z=3.91,95%CI:1.05~1.15,P=0.001)。多变量逻辑回归方程显示,在中性粒细胞和 PCT 不变的情况下,肝素结合蛋白每增加一个值,患者发生细菌感染的几率就增加 1.12 倍。ROC分析显示,肝素结合蛋白结合中性粒细胞和PCT对细菌感染有更好的预测价值[AUC=0.935, 95%CI:0.870~0.977]:肝素结合蛋白可预测严重多发性创伤患者的细菌感染。结论:肝素结合蛋白可预测严重多发性创伤患者的细菌感染,将肝素结合蛋白、PCT 和中性粒细胞结合使用可提高细菌感染的预测能力。
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