摘要
目的回顾脓毒症患者入院时血清CRP/PA,了解其对脓毒症预后的评估价值,寻找早期判断患者预后情况的有效指标。方法采用回顾性队列研究,收集首都医科大学宣武医院2017-05～2018-04收治的脓毒症住院患者。根据患者住院期间转归情况分为生存组和死亡组。收集患者的完整临床资料,分析两组间临床资料差异,临床指标与APACHEⅡ评分、SOFA评分的相关性,应用ROC曲线分析各因素对脓毒症患者预后的预测价值。结果共纳入患者65例,年龄(67. 06±16. 51)岁。生存组患者44例,年龄为(63. 82±16. 84)岁,死亡组患者21例,年龄为(73. 86±13. 80)岁,两组年龄比较差异存在统计学意义(P=0. 021)。住院患者脓毒症的死亡率为32. 3%。与死亡组比较,生存组PA水平高,CRP/PA比值小,APACHEⅡ评分和SOFA评分低,差异均有统计学意义(P <0. 05)。CRP、CRP/PA与APACHEⅡ存在弱相关(r=0. 308,0. 397,P <0. 05),PA与SOFA存在弱相关(r=-0. 268,P <0. 05)。应用ROC曲线评价CRP/PA、APACHEⅡ评分、SOFA评分对预后的评估价值,APACHEⅡ评分的AUC最大,为0. 893。CRP/PA的AUC为0. 669,其敏感度、特异度、阳性预测值(PPV)、阴性预测值(NPV)分别为80. 0%,50. 0%,76. 2%,51. 3%。结论 CRP/PA对于评价脓毒症患者预后简单便捷,有望作为快速评价脓毒症预后的指标。
Objective To evaluate the prognostic value of serum C-reactive protein to prealbumin ratio and to find an effective index for early prognosis in patients with sepsis.Methods A retrospective cohort study was conducted to collect sepsis inpatients admitted to Xuanwu Hospital of Capital Medical University from May 2017 to April 2018.Patients were divided into survival group and death group according to their prognosis.The complete clinical data of patients were collected,and the difference of clinical data between the two groups was analyzed.Laboratory examinations correlated with APACHEⅡscore and SOFA score were performed.The ROC curve was used to analyze the predictive value of each factor for the prognosis of sepsis patients.Results A total of 65 patients were enrolled,with an age of(67.06±16.51)years.There were 44 patients in survival group[(63.82±16.84)years old]and 21 patients in death group[(73.86±13.80)years old].There was a significant difference in age between the two groups(P=0.021).The mortality rate of sepsis in hospitalized patients was 32.3%.Compared with death group,higher PA level,lower CRP/PA ratio,lower APACHEⅡscore and SOFA score were found in survival group(P<0.05).CRP,CRP/PA were weakly correlated with APACHEⅡ(r=0.308,0.397,P<0.05),and PA was weakly correlated with SOFA(r=-0.268,P<0.05).The ROC curve was used to evaluate the prognostic value of CRP/PA,APACHEⅡscore,SOFA score.The AUC of APACHEⅡscore was the largest(0.893),and that of CRP/PA was 0.669.The sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of CRP/PA were 80.0%,50.0%,76.2%and 51.3%,respectively.Conclusion CRP/PA is simple and convenient for evaluating the prognosis of sepsis patients,and is expected to be used as a rapid prognostic indicator of sepsis.
作者
相前
李缨
宣琪
钱红娟
黄芸
任晓艺
吴琼
XIANG Qian;LI Ying;XUAN Qi;QIAN Hongjuan;HUANG Yun;REN Xiaoyi;WU Qiong(Nutrition Department,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《山西医科大学学报》
CAS
2019年第1期102-105,共4页
Journal of Shanxi Medical University
