The combined application of S-adenosine homocysteine,lactic acid and APACHE Ⅱ scores in evaluating the severity of sepsis
Objective:To evaluate the value of S-adenosine homocysteine(SAH)and lactic acid(Lac)com-bined with acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in different severity of patients with sepsis.Methods:The clinical data of 86 patients with sepsis who were admitted to the emergency department of the Second Hospital of Shanxi Medical University from January 2021 to January 2024 according to sepsis 3.0 criteria were retrospectively analyzed.According to whether the patients had shock at admission,they were divid-ed into sepsis group(40 cases)and septic shock group(46 cases).The basic data,early disease severity score and early serological indicators of the two groups were compared to find independent risk factors for the severity of sepsis,and receiver operating characteristic(ROC)was drawn.To explore the value of relevant indicators in eval-uating the severity of sepsis.Results:There was no significant difference in the basic information such as age,sex and infection site between the two groups(P＞0.05).The scores of SAH([127.2±25.4]nmol/L),Lac([4.8±3.2]mmol/L)and APACHE Ⅱ([17.5±6.4]points)in septic shock group were significantly higher than those in sepsis group([100.2±17.9]nmol/L,[3.2±2.6]mmol/L,[17.5±6.4]mmol/L,[14.9±5.3]min),and the difference between the two groups was statistically significant(P＜0.05).SAH was positively correlated with A-PACHEⅡ score and SOFA score in sepsis patients(P＜0.001).SAH(OR=1.059,95％CI:1.032-1.092,P=0.001)and APACHEⅡ score(OR=1.177,95％CI:1.019-1.360,P=0.027)were independent factors of disease severity in sepsis patients.When the optimal cutoff values of plasma SAH and Lac were 102.5nmol/L and 4.1 mmol/L,respectively,the AUC for predicting critical illness in sepsis patients was 0.833(95％CI:0.745-0.920,P＜0.001)and 0.693(95％CI:0.581-0.806,P＜0.001),APACHEⅡ score predicted the AUC of pa-tients with severe sepsis to be 0.782(95％CI:0.684-0.881,P＜0.001);The combined prediction of AUC for severe sepsis was 0.875(95％CI:0.803-0.947,P＜0.001).Conclusion:SAH,Lac and APACHE Ⅱ are of high value in evaluating the severity of sepsis,which can provide guidance for clinical intervention in time.
sepsisseptic shockS-adenosine homocysteinelactic acidacute physiology and chronic health evaluation Ⅱ
万方数据
维普
