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目的:探讨血清颗粒蛋白前体（PGRN）对成年人脓毒症患者的临床诊断价值。方法:选取2017年2月至2019年7月入住湖北医药学院附属东风医院的187例感染患者，根据脓毒症及脓毒性休克第3次国际共识定义诊断标准分为非脓毒症组（94例）和脓毒症组（93例），脓毒症组患者按感染程度分为脓毒性休克组（46例）和非脓毒性休克组（47例）两个亚组，比较两组及两个亚组入ICU 1 h内血清PGRN、降钙素原（PCT）、C-反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、血乳酸（Lac）水平，入ICU 24 h内急性生理学及慢性健康状况评分Ⅱ（APACHEⅡ）与序贯器官衰竭评估（SOFA）评分。采用二元Logistic回归模型分析PGRN与脓毒症之间的关系，绘制受试者工作特征（ROC）曲线，评价PGRN对脓毒症的诊断价值，并与PCT、CRP、IL-6、TNF-α、Lac的诊断价值进行比较。结果:脓毒症组血清PGRN、PCT、CRP、IL-6、TNF-α、Lac水平和APACHEⅡ、SOFA评分高于非脓毒症组[（129.25 ± 17.81）μg/L比（43.17 ± 7.68）μg/L、（5.92 ± 0.82）μg/L比（1.34 ± 0.17）μg/L、（64.07 ± 10.51）mg/L比（37.18 ± 5.44）mg/L、（111.68 ± 13.17）ng/L比（32.41 ± 5.61）ng/L、（86.06 ± 12.19）ng/L比（46.44 ± 7.63）ng/L、（2.96 ± 0.45）mmol/L比（1.47 ± 0.22）mmol/L、（23.62 ± 4.24）分比（11.74 ± 2.07）分、（14.84 ± 2.42）分比（1.36 ± 0.23）分]，差异均有统计学意义（n P < 0.05）；脓毒性休克组血清PGRN、PCT、CRP、IL-6、TNF-α、Lac水平均高于非脓毒性休克组[（143.29 ± 13.54）μg/L比（116.59 ± 10.73）μg/L、（7.64 ± 1.17）μg/L比（4.24 ± 0.59）μg/L、（74.49 ± 10.46）mg/L比（53.89 ± 8.41）mg/L、（124.48 ± 14.37）ng/L比（99.16 ± 13.61）ng/L、（95.91 ± 14.75）ng/L比（76.42 ± 11.24）ng/L、（3.52 ± 0.46）mmol/L比（2.45 ± 0.39）mmol/L]，差异均有统计学意义（ n P<0.05）。Logistic回归分析结果显示，SOFA评分、血清PGRN、PCT、CRP、IL-6、Lac水平为感染患者是否发生脓毒症的独立危险因素（n P<0.05）；ROC曲线分析显示，PGRN预测感染患者是否发生脓毒症的曲线下面积（AUC）为0.919（95%CI 0.870~ 0.954），高于CRP、IL-6、TNF-α、Lac，差异有统计学意义（n P<0.05）；PGRN预测脓毒症患者是否发生脓毒性休克的AUC为0.912（95% CI 0.835~0.961），高于CRP、IL-6、TNF-α、Lac，差异有统计学意义（n P<0.05）。n 结论:血清PGRN水平为诊断患者是否发生脓毒症及反映其严重程度的良好生物标志物，有一定的临床应用价值。“,”Objective:To investigate the value of serum progranulin (PGRN)in the clinical diagnosis of adult sepsis patients.Methods:One hundred and eighty-seveninfection patients admitted to the intensive care unit(ICU) of Affiliated Dongfeng Hospital, Hubei University of Medicinewere divided into non-sepsis group(94 patients) and sepsis group (93 patients)according to the third international consensus definitions for sepsis and septic shock. Patients in the sepsis group were divided into two subgroups according to the degrees of infection: septic shock group (46 patients) and non-septic shock group (47 patients). The levels of serum PGRN, procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and lactic acid (Lac) were compared between the two groups and subgroups within 1 h into the ICU, as well as the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) and sequential organ failure assessment (SOFA) scores within 24 h into the ICU. Logistic regression model was used to analyze the relationship between PGRN and sepsis. The receiver operating characteristic (ROC) curve of the subject was drawn. The diagnostic value of PGRN in sepsis was evaluated and compared with PCT, CRP, IL-6, TNF-α and Lac.Results:The levels of PGRN, PCT, CRP, IL-6, TNF-α, Lac and APACHEⅡ, SOFA scores in the sepsis group were higher than those in the non-sepsis group: (129.25 ± 17.81) μg/L vs. (43.17 ± 7.68) μg/L, (5.92 ± 0.82) μg/L vs. (1.34 ± 0.17) μg/L, (64.07 ± 10.51) mg/L vs. (37.18 ± 5.44) mg/L, (111.68 ± 13.17) ng/L vs. (32.41 ± 5.61) ng/L, (86.06 ± 12.19) ng/L vs. (46.44 ± 7.63) ng/L, (2.96 ± 0.45) mmol/L vs. (1.47 ± 0.22) mmol/L, (23.62 ± 4.24) scores vs. (11.74 ± 2.07) scores, (14.84 ± 2.42) scores vs. (1.36 ± 0.23) scores, and the differences were statistically significant (n P<0.05). The levels of PGRN, PCT, CRP, IL-6, TNF-α, Lac in the septic shock group were higher than those in non-septic shock group:(143.29 ± 13.54) μg/L vs. (116.59 ± 10.73) μg/L, (7.64 ± 1.17) μg/L vs. (4.24 ± 0.59) μg/L, (74.49 ± 10.46) mg/L vs. (53.89 ± 8.41) mg/L, (124.48 ± 14.37) ng/L vs.(99.16 ± 13.61) ng/L, (95.91 ± 14.75) ng/L vs. (76.42 ± 11.24) ng/L, (3.52 ± 0.46) mmol/L vs. (2.45 ± 0.39) mmol/L, and the differences were statistically significant (n P<0.05). Logistic regression analysis showed that SODA scores and serum PGRN, PCT, CRP, IL-6, Lac levels were independent risk factors for sepsis (n P<0.05). The ROC curve analysis showed that the area under the curve (AUC) of PGRN was higher than that of CRP, IL-6, TNF-α and Lac for predicting the occurrence of sepsis in infection patients (n P<0.05). The AUC of PGRN was higher than that of CRP, IL-6, TNF-α and Lac for predicting the occurrence of septic shock in infection patients (n P<0.05).n Conclusions:The levels of serum PGRN is a good biomarker for the diagnosis of sepsis and could reflect the severity. It has certain clinical value.