摘要
目的检测血清红细胞分布宽度(RDW)、血小板计数(PLT)、降钙素原(PCT)、白蛋白(ALB)水平,分析RDW/PLT、PCT/ALB比值与老年脓毒症患者预后的相关性。方法选取2020年1月-2022年1月南华大学附属长沙中心医院重症医学科治疗的126例老年脓毒症患者为研究对象。根据随访28 d生存情况将患者分为存活组(n=87)和死亡组(n=39)。比较两组年龄、性别、感染部位、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分及序贯器官衰竭评估(SOFA)评分,并进行Pearson相关性、预测价值及Kaplan-Meier生存曲线分析。结果死亡组患者APACHEⅡ评分、SOFA评分、RDW、RDW/PLT、PCT、PCT/ALB、肌酐、乳酸均显著高于存活组(t=7.267、12.903、9.998、8.947、10.845、11.734、9.037、6.789,P均<0.001),PLT、ALB显著低于存活组(t=10.845、7.607,P均<0.001),差异均有统计学意义。Pearson相关性分析显示,RDW、RDW/PLT、PCT、PCT/ALB与老年脓毒症患者APACHEⅡ、SOFA评分成正相关(r_(APACHEⅡ评分)=0.563、0.714、0.537、0.723,P均<0.001;r_(SOFA评分)=0.521、0.653、0.502、0.674,P均<0.001)。RDW/PLT与PCT/ALB联合诊断的曲线下面积为0.918,敏感度为0.923,特异度为0.816,约登指数为0.739,均显著高于单一指标的预测能力(P均<0.05)。结论RDW/PLT与PCT/ALB联合检测对老年脓毒症具有较高的预测价值。
Objective The serum red blood cell distribution width(RDW),platelet(PLT),procalcitonin(PCT),albumin(ALB)levels were tested,and the correlation between RDW/PLT ratio,PCT/ALB ratio and the prognosis of elderly sepsis patients was analyzed.Methods The clinical data of 126 patients with sepsis who were treated in the Department of Critical Care Medicine in the Affiliated Changsha Central Hospital,University of South China from January 2020 to January 2022 were selected for analysis.The patients were divided into survival group(n=87)and death group(n=39)according to the 28-day follow-up survival.Age,sex,site of infection,acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores,and sequential organ failure assessment(SOFA)scores were compared,and Pearson correlation,predictive value,and Kaplan-Meier survival curve analysis were performed.Results The APACHEⅡscore,SOFA score,RDW,RDW/PLT,PCT,PCT/ALB,Cr,Lac levels in the death group were significantly higher than those in the survival group(t=7.267,12.903,9.998,8.947,10.845,11.734,9.037,6.789;all P<0.001),while PLT and ALB levels were significantly lower than those in the survival group(t=10.845,7.607;all P<0.001).Pearson correlation analysis showed that RDW,RDW/PLT,PCT,PCT/ALB levels were positively correlated with APACHEⅡand SOFA scores in elderly sepsis patients(r_(APACHEⅡscore)=0.563,0.714,0.537,0.723;all P<0.001;r_(SOFA score)=0.521,0.653,0.502,0.674;all P<0.001).The combined diagnosis of RDW/PLT and PCT/ALB for area under the curve was 0.918,sensitivity was 0.923,specificity was 0.816,and Jordan index was 0.739,and were significantly higher than those predictive values of a single indicator(all P<0.05).Conclusion The combined diagnosis of RDW/PLT and PCT/ALB had a high predictive value for geriatric sepsis.
作者
伍小霞
王允
杨勇
WU Xiaoxia;WANG Yun;YANG Yong(Department of Critical Care Medicine,the Affiliated Changsha Central Hospital,University of South China,Changsha,Hunan,China)
出处
《热带医学杂志》
CAS
2024年第10期1449-1452,1471,共5页
Journal of Tropical Medicine
基金
湖南省科技创新计划项目(2021SK53403)。