The Value Of Serum Bone Morphogenetic Proteins 9,Growth Differentiation Factor 15 In The Early Recognition And Prognosis Evaluation Of Sepsis

Objective:The expression levels of serum bone morphogenic protein 9(BMP 9)and growth differentiation factor 15(GDF 15)in sepsis patients was tested,and the value of both in the early identification and prognosis evaluation of sepsis was investigated.Methods:There were thirty patients with sepsis admitted to the Intensive Care Unit of the Third Hospital of Shanxi Medical University from May 2021 to May 2022 were selected as the sepsis group,while 31 severe patients with non sepsis were selected as the case control group,and 23 adults who take part in physical examination in our hospital during the same period were selected as the healthy control group.Recording the name,gender,age,hospitalization number and length of hospitalization of the study subjects and collecting white blood cell count(WBC),neutrophil cell count count(NEUT),lymphocyte count(LY),platelet count(PLT),neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),monocyte(MONO),eosinophilic%(EO%),total bilirubin(TBil),serum creatinine(Scr),procalcitonin(PCT),C-reactive protein(CRP)and so on indicators data.According to the examination index,sequential organ failure(SOFA)score,acute physiology and chronic health(APACHE II)score were performed and serum BMP9 and GDF15 were determined in all study subjects for statistical analysis and comparison.Following up the survival of patients 28 days after the diagnosis of sepsis and dividing them into the survival group(n = 16)and the death group(n = 14).Clinical indices data were collected to compare the differences between the indicators of the two groups.Binary Logistic regression was used to analyze independent risk factors for the occurrence,development and prognosis of sepsis.The value of clinical laboratory indicators for early identification and prognosis of sepsis patients was assessed by the area under the curve(AUC)of the receiver operating characteristic curve(ROC).Pearson correlation analysis was used to analyze the correlation between BMP9 and GDF15 and each clinical indicators.Results:There were statistically significant differences in all indicators among the sepsis group,case control group and healthy control group(P <0.05).The levels of BMP9,PCT,CRP,SOFA score,and APACHE II score in the sepsis group were significantly higher than those in the case control group,with statistically significant differences(all P <0.05).SOFA score,APACHE II score,GDF15,and BMP9 were significantly higher in the sepsis death group than in the survival group,and the difference was statistically significant(P <0.05).BMP9,CRP,and SOFA were independent influencing factors for the onset of sepsis.BMP9 combined with CRP had higher AUC(0.845)than the AUC of the SOFA score(0.809).GDF15 and NLR were independent influencing factors for sepsis death,and the AUC of GDF15 combined with NLR in predicting the prognosis of sepsis patients was 0.898.BMP9 was associated with age,TBil,SOFA score and APACHE II score(P <0.05);GDF15 was associated with white blood cell count,neutrophil cell count,lymphocyte count,NLR,creatinine,and bilirubin(P <0.05).Conclusions:BMP9 has some value as a biomarker for early recognition of sepsis.The area under the ROC curve for predicting the development of sepsis in severe patients was 0.719.and it combined with CRP has a higher diagnostic value for the early identification value,its area under the ROC curve is 0.845.GDF15 is not valuable in the diagnosis of sepsis,but it combined with NLR can improve the predictive value of prognosis in patients with sepsis.The area under the ROC curve for predicting the prognosis of sepsis patients was0.898,the sensitivity was 80.0%,and the specificity was 100%.