摘要
目的探讨甘油三酯-葡萄糖指数(triglyceride-glucose index,TyG)在脓毒症患者预后中的价值。方法回顾性分析2017年7月至2021年7月本院急诊科收治的98例脓毒症患者临床资料。根据预后情况分为存活组(82例)和死亡组(16例),比较两组之间基线数据和临床生化等相关指标的差异。利用入院24h内空腹血糖(FBG)和甘油三酯(TG)结果计算TyG指数。采用Spearman相关分析TyG指数与脓毒症患者炎症指标及疾病严重程度评分相关性。进一步采用Logistic回归分析脓毒症患者预后危险因素。利用ROC曲线评估TyG指数在预测脓毒症患者预后的有效性。结果死亡组患者心率、急性生理学和慢性健康评分(APACHEⅡ评分)、序贯器官衰竭评分(SOFA评分)、降钙素原(PCT)、C反应蛋白(CRP)、白介素-6(IL-6)、FBG及TyG指数均显著高于存活组,而平均动脉压(MAP)低于存活组(P<0.05)。TyG指数与SOFA评分、APACHEⅡ评分呈正相关,与MAP呈负相关。Logistic回归分析表明,年龄、SOFA评分及TyG指数是脓毒症患者死亡的独立危险因素(P<0.05)。ROC曲线显示,TyG指数预测脓毒症患者预后的曲线下面积(AUC)为0.610,敏感度43.8%,特异度83.7%。结论TyG指数为脓毒症患者死亡的独立危险因素,可作为一个预测脓毒症患者预后的良好指标。
Objective To evaluate the prognostic value of Triglyceride Glucose(TyG)index in patients with sepsis.Methods The clinical data of 98 patients with sepsis from July2017to July2021were analyzed retrospectively.The TyG index was calculated based on the results of fasting blood glucose and triglyceride within 24 hours after admission.Patients were divided into survival group(n=82)and death group(n=16),and the differences in baseline data and clinical biochemistry and other relevant indicators such as gender,age,history of the disease,onset time,and site of infection were compared between the two groups.Spearman correlation analysis was performed to analyze the correlation between TyG index and inflammatory indicators and disease severity score.Multivariate logistic regression was used to analyze the risk factors affecting the prognosis of patients with sepsis.The predictive effect of TyG index on the prognosis of patients with sepsis was evaluated by the receiver operating characteristic curve.Results The heart rate,acute physiology and chronic health score(APACHEⅡscore),sequential organ failure score(SOFA score),procalcitonin(PCT)and other related infammatory indicators,FBG,and TyG index in the death group were significantly higher than those in the survival group,while the mean arterial pressure(MAP)was lower than that in the survival group(P<0.05).TyG index was positively correlated with SOFA score and APACHEⅡscore(r=0.153,0.147,respectively),and negatively correlated with MAP(r=-0.183)(P<0.05).Multivariate logistic regression analysis showed that age,SOFA score,and TyG index were independent risk factors in patients with sepsis(P<0.05).ROC curve analysis indicated that the area under the curve of TyG index in predicting the prognosis of patients with sepsis was 0.610,with a sensitivity of 43.8%and a specificity of 83.7%.Conclusions TyG index is an independent risk factor and can be used as a good indicator to predict the prognosis of patients with sepsis.
作者
刘成
周克兵
阳学风
魏红江
邓立普
Liu Cheng;Zhou Kebing;Yang Xuefeng;Wei Hongjiang;Deng Lipu(The Affiliated Nanhua Hospital,Department of Emergency,Hengyang Medical School,University of South China,Hengyang,China)
基金
湖南省卫健委科研计划项目(项目编号:B2017063)
南华大学一般项目(项目编号:南华科发[2019]02号-29)
