摘要
目的探讨降钙素原(PCT)联合清蛋白(ALB)对于复杂性腹腔感染(cIAI)致脓毒症患者预后的预测价值。方法选取2015年6月至2021年7月该院急诊收入的105例cIAI致脓毒症患者为研究对象。根据患者28 d预后分为死亡组(58例)和存活组(47例),收集并比较两组一般资料、PCT、ALB、血肌酐(Scr)等指标水平和急性生理与慢性健康系统Ⅱ(APACHEⅡ)评分,应用二元逻辑回归、绘制受试者工作特征(ROC)曲线分析其对于cIAI致脓毒症患者预后的预测价值。结果与存活组比较,死亡组PCT、Scr、APACHEⅡ评分更高,ALB水平更低,差异有统计学意义(P<0.05)。多因素分析结果提示,PCT(OR=1.045,95%CI:1.015~1.075)、ALB(OR:0.783,95%CI:0.698~0.878)和APACHEⅡ评分(OR=1.160,95%CI:1.058~1.271)是cIAI致脓毒症患者的影响因素(P<0.05)。亚组分析结果提示,与PCT≤7.69 ng/mL(Q1)比较,>7.69~22.85 ng/mL(Q2)、>22.85~66.91 ng/mL(Q3)和>66.91 ng/mL(Q4)均为cIAI致脓毒症患者预后的危险因素(P<0.05)。与ALB>33.50 g/L(Q4)比较,≤18.80 g/L(Q1)、>18.80~25.30 g/L(Q2)和>25.30~33.50 g/L(Q3)均为cIAI致脓毒症患者预后的危险因素(P<0.05)。PCT联合ALB对cIAI致脓毒症患者预后预测的曲线下面积(AUC)最大。结论PCT联合ALB对cIAI致脓毒症患者28 d预后具有较好的预测价值。
Objective To investigate the predictive value of serum albumin(ALB)combined with procalcitonin(PCT)in patients with complicated intra-abdominal infection(cIAI)induced sepsis.Methods A total of 105 patients with cIAI sepsis admitted to the emergency department of this hospital from June 2015 to July 2021 were selected.Patients were divided into a death group(58 patients)and a survival group(47 patients)according to their 28-day prognosis.Baseline data,PCT ALB,Blood creatinine(Scr),Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)scores,and other indicators were collected for inter-group analysis.Binary logistic regression and receiver operating characteristic(ROC)curve were used to analyze its predictive value for patients with cIAI-induced sepsis.Results Compared with the surviving group,the death group had higher PCT,Scr,and APACHEⅡ scores and lower ALB levels,with statistically significant differences(P<0.05).The results of the multifactorial analysis suggested that PCT(OR=1.045,95%CI:1.015-1.075),ALB(OR=0.783,95%CI:0.698-0.878),and APACHEⅡ scores(OR=1.160,95%CI:1.058-1.271)were the influencing factors of cIAI sepsis(P<0.05).Subgrouping analysis of ALB and PCT suggested that the higher the level of PCT[>7.69-22.85 ng/mL(Q2),>22.85-66.91 ng/mL(Q3)and>66.91 ng/mL(Q4)]compared with the lowest level of PCT≤7.69 ng/mL(Q1),the more likely patients were to have a poor prognosis.Compared with the highest level of ALB>33.50 g/L(Q4),the lower the level of ALB[≤18.80 g/L(Q1),>18.80-25.30 g/L(Q2)and>25.30-33.50 g/L(Q3)],the more suggestive of poor prognosis.The area under ROC curve of the combination of PCT and ALB was the largest.Conclusion The combination of ALB and PCT has a better prognostic value for CIAI-induced sepsis within 28 days.
作者
罗静智
宋沪刚
龙小红
张欣春
白礼嵩
吴胜男
刘振玉
LUO Jingzhi;SONG Hugang;LONG Xiaohong;ZHANG Xinchun;BAI Lisong;WU Shengnan;LIU Zhenyu(Department of Emergency,the First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330000,China)
出处
《重庆医学》
CAS
2023年第5期715-719,共5页
Chongqing medicine
基金
江西省卫生健康委员会科技计划项目(202130214)。
关键词
腹腔感染
脓毒症
降钙素原
清蛋白
预测
价值
abdominal infection
sepsis
procalcitonin
albumin
prediction
value
