摘要
目的:探究中心静脉-动脉血二氧化碳分压差[P(cv-a)CO_(2)]、乳酸、降钙素原(PCT)在评估脓毒性休克患者预后的价值。方法:收集本院2017年10月至2020年10月收治的141例脓毒性休克患者资料,根据预后分为存活组71例和死亡组70例。采用多因素logistic回归分析脓毒性休克患者血清P(cv-a)CO_(2)、乳酸和PCT水平与死亡的关系,且对脓毒性休克患者的血清P(cv-a)CO_(2)、乳酸和PCT水平行ROC曲线分析。结果:存活组的P(cv-a)CO_(2)、乳酸和PCT水平均低于死亡组(P<0.05)。多因素Logistic回归分析显示,脓毒性休克患者的血清P(cv-a)CO_(2)、乳酸和PCT水平为死亡的危险因素(P<0.05)。ROC曲线图显示,血清P(cv-a)CO_(2)、乳酸和PCT水平预测患者预后的曲线下面积(AUC)分别为0.951、0.958、0.971;95%CI分别为0.901~0.980、0.910~0.984、0.928~0.992;截断值分别为5.974、5.257、9.381;灵敏度分别为87.142%、90.001%、92.861%;特异度分别为88.731%、91.552%、91.552%。结论:脓毒性休克患者的血清P(cv-a)CO_(2)、乳酸和PCT水平较高与不良预后发生有关,且三项指标对脓毒性休克患者预后的预测效能好。
Objective:To explore the prognostic value of central venous-to-arterial carbon dioxide difference[P(cv-a)CO_(2)],lactate and procalcitonin(PCT)in septic shock patients.Methods:The data of 141 septic shock patients admitted to the hospital between October 2017 and October 2020 was collected.The patients were divided into survival group(71 cases)and death group(70 cases)according to the prognosis.Multivariate logistic regression analysis was performed to analyze the relationship of serum P(cv-a)CO_(2),lactate and PCT levels with death of septic shock patients.Meanwhile,ROC curve analysis of serum P(cv-a)CO_(2),lactate and PCT levels was conducted.Results:The levels of P(cv-a)CO_(2),lactate and PCT in survival group were lower than those in death group(P<0.05).Multivariate logistic regression analysis found that serum P(cv-a)CO_(2),lactate and PCT were risk factors for death of patients with septic shock(P<0.05).ROC curve analysis showed that the area under the curve(AUC)values of serum P(cv-a)CO_(2),lactate and PCT to predict the prognosis were 0.951,0.958,and 0.971,respectively.The 95%CIs were 0.901-0.980,0.910-0.984,and 0.928-0.992.The cutoff values were 5.974,5.257 and 9.381.The sensitivity was 87.142%,90.001%and 92.861%.The specificity was 88.731%,91.552%and 91.552%.Conclusion:High serum levels of P(cv-a)CO_(2),lactate and PCT are related to poor prognosis of septic shock patients.All of the three have good prognostic value in septic shock patients.
作者
严思
湛文世
颜光寰
王庭学
YAN Si;ZHAN Wenshi;YAN Guanghuan(Qionghai People's Hospital, Hainan Qionghai 571400,China)
出处
《河北医学》
CAS
2022年第6期892-895,共4页
Hebei Medicine
基金
海南省卫生计生行业科研项目,(编号:19A200152)。
