摘要
目的 分析血浆可溶性尿激酶型纤溶酶原激活物受体(plasma soluble urokinase-type plasminogen activator receptor, SUPAR)在急诊严重创伤患者的价值。方法 抽选开封市中心医院2020年2月至2022年2月的急诊严重创伤患者102例,根据生理评分和器官衰竭评分将患者分为病重组(n=62)、病轻组(n=40),对两组进行血浆SUPAR测定和损伤程度评分,比较两组一般资料,用logistic法分析急诊严重创伤患者病情的独立影响因素,采用ROC曲线分析血浆SUPAR水平、损伤程度评分及其两者联合对急诊严重创伤患者病情严重程度的预测价值,并以ROC曲线分析所得的临界值为标准,观察比较血浆SUPAR水平联合损伤程度评分与单一损伤程度评分预测急诊严重创伤患者病情严重程度的敏感性、特异度、准确值、kappa值及阳阴性预测值。结果 病重组血浆SUPAR水平、损伤程度评分较病情组明显高[(6.98±2.75)ng/mL vs(4.25±1.47)ng/mL;(30.72±2.57)分vs(23.45±2.75)分,P<0.05]。logistic多因素回归分析结果显示,血浆SUPAR水平、损伤程度评分过高是急诊严重创伤患者病情严重的独立危险因素(OR=2.038、2.121,P<0.05);ROC曲线结果表明,血浆SUPAR水平、损伤程度评分单一及联合应用均可预测急诊严重创伤患者病情严重程度(P<0.05),且两者联合预测的AUC大于两者单一预测(P<0.05)。血浆SUPAR水平、损伤程度评分预测急诊严重创伤患者的敏感度分别为80.65%、95.16%,特异性分别为80%、95%,准确值分别为80.39%、95.10%,阳性预测值分别为86.21%、96.72%,阴性预测值分别为72.73%、92.68%,kappa值分别为0.596、0.898,差异有统计学意义(P<0.05)。血浆SUPAR水平联合损伤程度评分预测急诊严重创伤患者的敏感性、特异度、准确值、kappa值及阳阴性预测值大于单一损伤程度评分,差异有统计学意义(P<0.05)。结论 SUPAR可预测急诊严重创伤患者病情严重程度,联合损伤评分应用效果更佳
Objective To analyze the value of plasma soluble urokinase-type plasminogen activator receptor(SUPAR) in emergency patients with severe trauma. Methods A total of 102 patients with severe trauma in the emergency department of our hospital from February 2020 to February 2022 were selected. According to the physiological score and organ failure score, the patients were divided into two groups: reorganized disease(n=62) and mild disease group(n=40). Plasma SUPAR measurement and injury degree score were performed for the two groups, and the general data of the two groups were compared. logistic method was used to analyze the independent influencing factors of the condition of patients with severe trauma in emergency department. The predictive value of the severity of severe trauma patients, and the critical value obtained by ROC curve analysis was used as the standard to observe and compare the sensitivity and specificity of plasma SUPAR level combined with injury severity score and single injury severity score in predicting the severity of emergency severe trauma patients, exact value, kappa value and positive and negative predictive value. Results Plasma SUPAR levels and injury severity scores in the diseased group were significantly higher than those in the diseased group [(6.98±2.75) ng/mL vs(4.25±1.47) ng/mL;(30.72±2.57) points vs(23.45±2.75) points, P< 0.05]. Logistic multivariate regression analysis showed that high plasma SUPAR level and injury severity score were independent risk factors for serious illness in emergency department patients with severe trauma(OR=2.038, 2.121, P<0.05). Both single and combined application of severity score can predict the severity of severe trauma patients in emergency department(P<0.05), and the AUC predicted by the combination of the two is greater than the single prediction of the two(P<0.05). The sensitivity of plasma SUPAR level and injury severity score in predicting severe trauma patients in emergency department was 80.65% and 95.16%, the specificity was 80% and 95%
作者
朱肖利
ZHU Xiao-li(Emergency Medicine Department,Kaifeng Central Hospital,Kaifeng,Henan 475000,China)
出处
《医药论坛杂志》
2022年第23期59-63,共5页
Journal of Medical Forum
关键词
可溶性尿激酶型纤溶酶原激活物受体
急诊
严重创伤
病情严重程度
Soluble urokinase-type plasminogen activator receptor
Emergency department
Severe trauma
Severity of illness
