摘要
目的 探究序贯器官衰竭估计(SOFA)评分联合血清白细胞介素-6(IL-6)、C反应蛋白(CRP)及乳酸对重症肺炎28d预后的预测效能.方法 选取本院2020年到2023年98例重症肺炎患者,根据其28d后的死亡情况,分为生存组(n=60),死亡组(n=38),收集患者的一般资料,根据中文版的简化SOFA评分计算分数;在入院的次日空腹抽取5 ml静脉血和2 ml外周动脉血,采用酶联免疫吸附法检测血清IL-6、CRP水平检测采用透射比浊法进行测定.血乳酸水平用比色法检测;采用Logistic回归分析重症肺炎28d死亡的危险因素;采用ROC曲线分析SOFA评分联合血清IL-6、CRP、乳酸检测水平对重症肺炎28d预后的预测效能.结果 两组患者的性别、年龄、基础疾病个数和体重质量情况均无统计学差异(P＞0.05);死亡组的SOFA评分分数以及血清IL-6、CRP、乳酸检测水平均高于生存组,且差异具有统计学意义(P＜0.05);多因素Logistic回归结果显示,SOFA评分分数以及IL-6、CRP、乳酸检测水平都是重症肺炎患者28d死亡的危险因素(P＜0.05);由ROC曲线分析可得,SOFA评分以及血清IL-6、CRP、乳酸检测水平预测重症肺炎28d预后的AUC分别为:0.816,0.719.0.782,0.799;灵敏度分别为:65.8％,57.9％,78.9％,63.2％;特异度分别为:88.3％,80.0％,81.7％,88.3％;四个指标联合预测的 AUC 为0.917,灵敏度为80.9％,特异度为90.3％.结论 SOFA评分分数以及IL-6、CRP、乳酸检测水平越高的重症肺炎患者,其28d死亡的风险越高;SOFA评分联合血清IL-6、CRP、乳酸检测水平对于重症肺炎28d预后具有较高的预测效能.
Abstract
Objective To explore the predictive efficacy of Sequential Organ Failure Assessment(SOFA)score com-bined with serum interleukin-6(IL-6),C-reactive protein(CRP)and lactate on 28-day prognosis of severe pneumonia.Methods Ninety-eight patients with severe pneumonia in our hospital from 2020 to 2023 were selected,and classified into survival group(n=60)and death group(n=38)according to the 28-day mortality status.The clinical data of participants were collected,and patients were assessed using SOFA.Milliliters of fasting venous blood(5 ml)and peripheral arterial blood(2 ml)were subjected to complete IL-6,CRP and lactate tests using transmission turbidimetry and colorimetry.Then Logistic regression analysis was performed to screen the risk factors for 28-day mortality of severe pneumonia,and receiver operating characteristic(ROC)curve was plotted to evaluate the predictive efficacy of SOFA score combined with serum IL-6,CRP and lactate on the 28-day prognosis of severe pneumonia.Results No statistical difference was reported between two groups in gender,age,number of comorbid underlying diseases,body weight and body mass index(P＞0.05).SOFA score,serum IL-6,CRP,and lactate levels in death group were higher than those in survival group,with statistical difference(all P＜0.05).ROC curve denoted showed that the area under the curve(AUC)of SOFA score,serum IL-6,CRP,and lactate for predicting the 28-day prognosis of severe pneumonia was 0.816,0.719,0.782 and 0.799,with sensitivity of 65.8％,57.9％,78.9％and 63.2％,and specificity of 88.3％,80.0％,81.7％,and 88.3％,respectively.The AUC,sen-sitivity and specificity of combined test of SOFA score,serum IL-6,CRP,and lactate for predicting the 28-day prognosis of severe pneumonia were 0.917,80.9％and 90.3％.Conclusion Severe pneumonia patients with higher SOFA score,ser-um IL-6,CRP,and lactate suffer a higher risk of 28-day mortality rate,furthermore,the combined test of SOFA score,serum IL-6,CRP,and lactate is of great predictive value for 28-day mortality in patients.
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