摘要
目的探讨血清乳酸、降钙素原、前白蛋白评估脓毒症患者病情和预后的价值。方法回顾性分析2019年2月-2020年10月收治的124例脓毒症患者的临床资料,根据30 d内预后情况将患者分为死亡组38例和存活组86例,比较2组患者一般资料和血清学指标,采用Pearson相关性分析血清学指标与APACHEⅡ评分、SOFA评分的关系,采用Logistic回归分析脓毒症患者预后的影响因素,采用受试者工作特征曲线分析血清学指标预测脓毒症患者预后的价值。结果死亡组患者合并器官损伤数量、APACHEⅡ评分、SOFA评分明显高于存活组(P<0.05);2组患者总胆红素、尿素氮、肌酐、白细胞计数、中性粒细胞比例、白蛋白水平比较差异无统计学意义(P>0.05),死亡组患者降钙素原、C-反应蛋白、乳酸水平明显高于存活组(P<0.05),前白蛋白水平明显低于存活组(P<0.05);Pearson相关性分析显示,脓毒症患者降钙素原、C-反应蛋白、乳酸与APACHEⅡ评分、SOFA评分呈正相关(r值分别为0.720,0.617,0.728.0.768,0.656,0.759,P<0.05),前白蛋白与APACHEⅡ评分、SOFA评分呈负相关(r值分别为-0.672、-0.724,P<0.05);Logistic回归分析显示,降钙素原、乳酸、前白蛋白、器官损伤数量、APACHEⅡ评分、SOFA评分与脓毒症患者预后关系密切(P<0.05),C-反应蛋白与预后无显著相关性(P>0.05);ROC曲线分析显示,降钙素原、乳酸、前白蛋白及联合检测预测脓毒症患者死亡的AUC分别为0.804,0.781,0.772,0.886,联合检测的AUC明显高于单一指标(P<0.05)。结论血清乳酸、降钙素原、前白蛋白与脓毒症患者预后关系密切,可以用于预后评估。
Objective To investigate the value of serum lactate,procalcitonin and prealbumin in evaluating the prognosis of pyemia.Methods Clinical data of 124 pyemia patients admitted from February 2019 to October 2020 were retrospectively analyzed,the patients were divided into the death group(n=38)and the survival group(n=86)according to the prognosis within 30 days,and the general data and serological indexes of the two groups were compared.Pearman correlation was used to analyze the relationship between serological indicators and APACHE Ⅱ score and SOFA score,and Logistic regression was used to analyze the prognostic factors of pyemia patients.The receiver operating characteristic curve was used to analyze the value of serological indicators in predicting the prognosis of pyemia patients.Results The number of combined organ damage,APACHE Ⅱ score and SOFA score in the death group were significantly higher than those in the survival group(P<0.05).There was no statistical significance on the difference in total bilirubin,urea nitrogen,creatinine,white blood cell count,neutrophil ratio,and albumin level between the two groups of patients(P>0.05).The levels of procalcitonin,C-reactive protein,and lactate in the death group were significantly higher than those in the survival group(P<0.05),and the levels of prealbumin were significantly lower than those in the survival group(P<0.05).Pearson correlation analysis showed that procalcitonin,C-reactive protein,and lactic acid were positively correlated with APACHE Ⅱ score and SOFA score in pyemia patients(r=0.720,r=0.617,r=0.728,r=0.768,r=0.656,r=0.759,P<0.05).Prealbumin is negatively correlated with APACHE H score and SOFA score(r=-0.672,r=-0.724,P<0.05).Logistic regression analysis showed that procalcitonin,lactate,prealbumin,number o£organ damage,APACHE Ⅱ scores,SOFA scores were closely related to the prognosis(P<0.05),and there was no significant corelation between C-reacive protein and prognosis(P>0.05).ROC curve analysis showed that the AUC of procalcitonin,lactic a
作者
余春燕
徐红青
陈毓
吴德军
YU Chun-yan;XU Hong-qing;CHEN Yu;WU De-jun(Emergency Department,Quzhou Hospital Affiliated to Wenzhou Medical University(Quzhou People's Hospital),Quzhou,Zhejiang 324000,China)
出处
《中国卫生检验杂志》
CAS
2021年第23期2899-2902,2908,共5页
Chinese Journal of Health Laboratory Technology
关键词
脓毒症
血乳酸
降钙素原
前白蛋白
预后
Pyemia
Blood lactale
Procalcitonin
Prealbumin
Prognosis
