medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2019-1-16(391)-37-43medalphabet-1291Research ArticleСтатьиСвободный гемоглобин и сепсисFree hemoglobin and sepsisОрловЮ. П.OrlovYu. P.

Кафедра анестезиологии и реаниматологии

г. Омск

ГовороваН. В.GovorovaN. V.

Кафедра анестезиологии и реаниматологии

г. Омск

ХрамыхТ. П.KhramykhT. P.

Кафедра оперативной хирургии и топографической анатомии

г. Омск

ГлущенкоА. В.GlushchenkoA. V.НочнаяЮ. А.NochnayaYu. А.

Кафедра анестезиологии и реаниматологии

г. Омск

ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России; БУЗОО «Городская клиническая больница скорой медицинской помощи № 1», г. ОмскРоссияOmsk State Medical University; Сity Clinical Emergency Hospital N 1, OmskRussian FederationФГБОУ ВО «Омский государственный медицинский университет» Минздрава РоссииРоссияOmsk State Medical UniversityRussian FederationБУЗОО «Городская клиническая больница скорой медицинской помощи № 1», г. ОмскРоссияСity Clinical Emergency Hospital N 1, OmskRussian Federation201928112019116Неотложная медицина и кардиология3743Copyright © Орлов Ю.П., Говорова Н.В., Храмых Т.П., Глущенко А.В., Ночная Ю.А., 20192019Орлов Ю.П., Говорова Н.В., Храмых Т.П., Глущенко А.В., Ночная Ю.А.Orlov Y.P., Govorova N.V., Khramykh T.P., Glushchenko A.V., Nochnaya Y.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1291Цель исследования

Цель исследования: определение возможности использования концентрации свободного гемоглобина как раннего прогностического маркера и предиктора летальности при сепсисе.

Материалы и методы

Материалы и методы. В исследовании у 60 пациентов в возрасте 47,6 ± 7,2 года с сепсисом (30,4 ± 2,1 балла по шкале Манхейма для оценки тяжести перитонита) методами современной статистики (ROC-анализ) была проверена гипотеза, действительно ли уровень свободного гемоглобина, определяемый в первые сутки от момента госпитализации, может быть использован в качестве биомаркера для диагностики и прогноза тяжелого сепсиса. Информативность критерия сравнивали с информативностью прокальцитонинового теста.

Результаты

Результаты. Настоящее исследование показало, что концентрация свободного гемоглобина выше средней величины, измеренной в первый день течения тяжелого сепсиса, прямо связана с увеличением 30-дневной смертности, а уровень свободного гемоглобина в 1-е сутки заболевания обладает высокой чувствительностью, специфичностью и с точностью до 96,7 % может определить исход сепсиса.

Заключение

Заключение. Концентрация свободного гемоглобина выше средней величины, выявленная в первый день течения тяжелого сепсиса, прямо связана с увеличением 30-дневной смертности, а исследованный уровень свободного гемоглобина в 1-е сутки течения заболевания обладает высокой долей чувствительности и специфичности. Уровень свободного гемоглобина является чувствительным предиктором исхода сепсиса в первые сутки после начала терапии, но полученные результаты никак не исключают необходимости использования прокальцитонинового теста у септических пациентов, а напротив, диктуют целесообразность сочетания двух указанных критериев для оценки исхода тяжелого септического процесса, что требует продолжения исследований.

Purpose of Research

Purpose of Research: to determine whether we can use free hemoglobin concentration as early prognostic marker and a predictor of mortality in sepsis.

Materials and Methods

Materials and Methods. In a retrospective study in 60 patients aged 47.6 ± 7.2 years with sepsis (30.4 ± 2.1 points on the Mannheim’s scale for evaluation of the severity of peritonitis) modern methods of statistics (ROC-analysis) hypothesis was tested, whether level of free hemoglobin in the first 24 hours from the moment of admission can be used as a biomarker for diagnosis and prognosis for severe sepsis. Informative criterion was compared with the information of the procalcitonin test.

Results

Results. The present study had shown that the above average free hemoglobin concentration, measured on the first day of the heavy flow of sepsis, is directly connected with increased 30-days mortality, and the level of free hemoglobin in a first day of the disease has high sensitivity, specificity, and can determine the outcome of sepsis with accuracy up to 96.7 %.

Conclusion

Conclusion. Free hemoglobin concentration above medium size identified on the first day of the currents of severe sepsis, is directly related to increased 30-day mortality, and researched level of free hemoglobin in day 1 of the disease has a high proportion of sensitivity and specificity. Level of free hemoglobin is predictor outcome of sepsis in the first 24 hours after the start of therapy, but the results did not rule out the need to use the necessary test from septic patients, but rather the feasibility of combining the two dictates the criteria to assess the outcome of severe septic process that requires further research.

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The authors declare that there are no conflicts of interest present.