摘要
目的探讨ROC曲线评估胰岛素抵抗指数(IRI)在预测腹部手术患者预后的价值。方法随机抽取广州市花都区第二人民医院腹部开放性大手术患者50例,于术后当天及手术后3、6 d检测患者血清血糖和胰岛素水平,计算IRI,记录患者手术侵袭度评分、术后并发症和术后肠功能恢复时间,采用ROC曲线评估IRI对患者上述预后特征的预测价值。并根据IRI分为≤1组、1～2组和≥2组。结果 IRI≤1组的手术侵袭度评分最低,与其余两组比较差异有统计学意义(P<0.05),但三组间的术后肠功能恢复时间比较差异无统计学意义(P>0.05)。IRI≥2组患者的术后并发症发生率最高,显著高于IRI≤1组和1～2组(P<0.05)。ROC曲线显示,IRI预测手术侵袭度评分、术后并发症和术后肠功能恢复时间的曲线下面积(AUC)分别为0.778、0.841、0.658(P=0.001)。结论 IRI与腹部手术患者预后状况具有密切关系,其在预测患者手术侵袭度评分、术后并发症和术后肠功能恢复时间等具有较高的价值。
Objective To explore the value of ROC curve in evaluating insulin resistance index in predicting the prognosis of patients undergoing abdominal surgery. Methods 50 patients with open abdominal surgery in our hospital were randomly selected. The patients were tested for serum glucose and insulin levels on the day of surgery and 3 and 6 days after surgery. The insulin resistance index was calculated and the surgical invasiveness score and postoperative complications and the recovery time of postoperative intestinal function were recorded. ROC curve was used to evaluate the predictive value of insulin resistance index on the prognostic characteristics of patients. According to the insulin resistance index, it was divided into ~〈1 group, 1~2 group and i〉2 group. Results The scores of surgical invasiveness index ~〈1 had the lowest scores, and the difference was statistically significant （P〈0.05）. However, there was no significant difference in postoperative intestinal function recovery between the three groups （P〉0.05）. The incidence of postoperative complications was highest in patients with insulin resistance index /〉2, which was significantly higher than that in insulin resistance index~〈l group and 1-2 group （P〈0.05）. The ROC curve showed that the AUC of the insulin resistance index predicting the surgical invasiveness score, postoperative complications, and postoperative intestinal function recovery time were 0.778, 0.841 and 0.658, respectively （P=0.001）. Conclusion The insulin resistance index is closely related to the prognosis of patients undergoing abdominal surgery. It has high value in predicting the surgical invasion score, postoperative complications and postoperative intestinal function recovery time.
作者
邹向竞
杨新霞
ZOU Alang-jmg;YANG Xm-xla(The Second People＇s Hospital of Huadu,Guangzhou,Guaagdong 510850,China)
出处
《热带医学杂志》
CAS
2018年第9期1202-1205,共4页
Journal of Tropical Medicine
关键词
胰岛素抵抗指数
腹部手术
预后
Insulin resistance index
Abdominal surgery
Prognosis
