摘要
目的探讨重症医学科(ICU)脓毒症患者第三腰椎(L3)腰大肌面积指数(PMI)预测其死亡风险的评估价值。方法采用单中心回顾性的队列研究。纳入自2020年6月至2023年6月在山西医科大学第一医院ICU收治的121例确诊脓毒症患者。采集患者的一般资料、炎症指标等。Slice Omatic软件测量第三腰椎腰大肌面积(L3-PMA),计算L3-PMI。根据临床结局分为生存组63例与死亡组58例,分析各指标与病死率的相关性。采用logistic回归模型筛选独立的危险因素,采用受试者工作特征(ROC)曲线评估各指标预测脓毒症患者死亡风险的准确性。结果研究结果表明,死亡组L3-PMI值明显下降。多因素logistic回归分析结果表明PMI[OR=0.651(95%CI:0.43-0.986),P=0.043]、白细胞[OR=1.065(95%CI:1.009-1.125),P=0.023]、降钙素原[OR=1.008(95%CI:1.001-1.014),P=0.020]是影响脓毒症患者预后的独立危险因素。ROC曲线显示,L3-PMI曲线下面积(AUC)为0.736(P<0.001),白细胞的AUC为0.701(P<0.001),降钙素原的AUC为0.785(P<0.001)。结论L3-PMI结合白细胞、降钙素原对脓毒症患者预后均有预测价值,L3-PMI可成为脓毒血症患者预后的参考因素之一。
Objective To investigate the evaluation value of psoas major muscle area index(PMI)of the third lumbar vertebra(L3)in predicting the death risk of sepsis in intensive care unit(ICU)patients with sepsis.Methods A single-center retrospective cohort study was adopted.A total of 121 patients with sepsis admitted to ICU of the First Hospital of Shanxi Medical University from June 2020 to June 2023 were included.The general data and inflammatory indices of patients were collected.Slice Omatic software was used to measure psoas major muscle area of the third lumbar vertebra(L3-PMA)and calculate the L3-PMI.According to the clinical outcome,they were divided into the survival group(n=63)and the death group(n=58),and the correlation between each index and mortality rate was analyzed.logistic regression model was used to screen independent risk factors,and receiver operating characteristic(ROC)curve was used to evaluate the accuracy of each index in predicting the death risk of patients with sepsis.Results The research results indicated that the L3-PMI value of the death group decreased significantly.The results of multivariate logistic regression analysis showed that L3-PMI(OR=0.651[95%CI:0.43-0.986],P=0.043),white blood cells(OR=1.065[95%CI:1.009-1.125],P=0.023),and procalcitonin(OR=1.008[95%CI:1.001-1.014],P=0.020)were independent risk factors affecting the prognosis of patients with sepsis.The ROC curve indicated that the area under the L3-PMI curve(AUC)was 0.736(P<0.001),the AUC of whi te blood cells was 0.701(P<0.001),and the AUC of procalcitonin was 0.785(P<0.001).Conclusion L3-PMI combined with white blood cells and procalcitonin both has predictive value for the prognosis of patients with sepsis,and L3-PMI can be one of the reference factors for the prognosis of patients w ith sepsis.
作者
关贵平
李原媛
冯鹏飞
赵宇彤
周晋萌
GUAN Guiping;LI Yuanyuan;FENG Pengfei;ZHAO Yutong;ZHOU Jinmeng(Department of Critical Care Medicine,the First Hospital of Shanxi Medical University,Shanxi,Taiyuan 030001,China)
出处
《中国医药科学》
2024年第19期156-160,共5页
China Medicine And Pharmacy
基金
山西省基础研究计划项目(202203021222376)。
关键词
脓毒血症
第三腰椎腰大肌面积指数
死亡风险
预测价值
Sepsis
Psoas major muscle area index of the third lumbar verte bra
Risk of death
Predicted value
