摘要
目的:探讨老年急性重度一氧化碳中毒(acute severe carbon monoxide poisoning,ASCMP)患者血系统性免疫炎症指数(systemic immune-inflammation index,SII)和单核细胞与高密度脂蛋白胆固醇比值(monocyte count to high-density lipoprotein ratio,MHR)与院内心血管不良事件发生的相关性。方法:选取我院急诊科2017年2月—2022年12月收入院的老年ASCMP患者(老年组)116例,其中合并心血管不良事件56例(不良事件组),无不良事件(无事件组)60例;另选取非老年ASCMP患者50例为对照组。所有患者均在入院时(0 h)及入院12 h、48 h,检测SII、MHR,同时记录患者急性生理学及慢性健康状况评分系统(APACHE)Ⅱ评分;分析SII、MHR和院内心血管不良事件发生的相关性,采用受试者工作特征(ROC)曲线评估SII、MHR及两指标联合检测对老年ASCMP患者发生心血管不良事件的预测价值。结果:入院时及入院12 h、48 h,老年组SII、MHR和APACHEⅡ评分均高于对照组,不良事件组高于无事件组,差异有统计学意义(均P<0.05)。相关分析结果显示,SII、MHR水平与院内心血管不良事件发生呈正相关(r_(入院时)=0.744、0.758,r_(12 h)=0.813、0.830,r_(48 h)=0.759、0.807,均P<0.001),以入院12 h相关性最高。入院后12 h,老年ASCMP患者SII、MHR及两者联合预测发生院内心血管不良事件的ROC曲线下面积分别为0.828、0.819和0.868,灵敏度分别为0.813、0.804和0.850,特异度分别为0.786、0.767和0.821。结论:SII、MHR可作为老年ASCMP患者发生院内心血管不良事件的早期预测指标,联合检测具有更高的临床应用价值。
Objective To investigate the correlation of blood system immune inflammatory index(SII) and monocyte to high-density lipoprotein cholesterol ratio(MHR) with the occurrence of nosocomial cardiovascular adverse events in elderly patients with acute severe carbon monoxide poisoning(ASCMP).Methods Elderly ASCMP patients(elderly group) who were admitted to the emergency department of our hospital from February 2017 to December 2022 were divided into adverse event group(56 cases) and non-event group(60 cases) according to with or without cardiovascular adverse events. Fifty non-elderly ASCMP patients were selected as control group. SII, MHR levels at admission, 12 hours and 48 hours after admission of all patients were detected. At the same time, the acute physiology and chronic health status scoring system(APACHE Ⅱ) scores were recorded. Analyze the correlation between SII, MHR and in-hospital cardiovascular adverse events. The receiver operating characteristic(ROC) curve was used to evaluate the predictive value of SII, MHR and the combined detection of the two indicators in elderly ASCMP patients with cardiovascular adverse events.Results At admission, 12 hours, and 48 hours, the SII, MHR and APACHE Ⅱ scores of the elderly group were higher than those of the control group, and those of the adverse event group were higher than those of the non-event group, and the differences were statistically significant(all P < 0.05). The results of correlation analysis showed that the levels of SII and MHR were positively correlated with the occurrence of nosocomial cardiovascular adverse events(r0 h=0.744, 0.758;r12 h=0.813, 0.830;r48 h=0.759, 0.807;all P < 0.001), with the highest correlation at 12 hours after admission. At 12 hours after admission, the area under the ROC curve(AUC) of SII, MHR and their combination predicting the occurrence of nosocomial cardiovascular adverse events in elderly ASCMP patients were 0.828, 0.819 and 0.868, respectively, with the sensitivity of 0.813, 0.804 and 0.850, respectively, and the sp
作者
李佳
齐洪娜
宫平
王园园
肖青勉
王维展
LI Jia;QI Hongna;GONG Ping;WANG Yuanyuan;XIAO Qingmian;WANG Weizhan(Department of Emergency,Harrison International Peace Hospital Affiliated to Hebei Medical University,Hengshui,Hebei,053000,China)
出处
《临床急诊杂志》
CAS
2023年第6期292-296,共5页
Journal of Clinical Emergency
基金
衡水市科学技术研究与发展计划项目(No:2021014077Z)。
