全身炎症反应指数对脓毒症患者早期预后的临床研究
Clinical study on the early prognosis of the systemic inflammatory response index in patients with sepsis
习佑民 1吕传柱2
作者信息
- 1. 海南医学院急诊创伤学院,海南 海口 571199
- 2. 四川省医学科学院·四川省人民医院(电子科技大学附属医院),四川 成都 610072
- 折叠
摘要
目的 探讨全身炎症反应指数(systemic inflammation response index,SIRI)对脓毒症患者28d死亡的预测价值.方法 回顾性分析2019年7月至2022年12月海南医学院第一附属医院中心ICU、急诊ICU和创伤ICU收治的150 例脓毒症患者的临床资料,并计算SIRI,根据28d预后分为存活组与死亡组,比较两组患者临床资料;采用逐步回归法进行多因素分析,绘制受试者工作特性曲线(ROC),分析SIRI对脓毒症预后的预测价值.根据ROC曲线确定的截断值绘制Kaplan-Meier生存曲线.结果 存活组与死亡组白细胞计数(WBC)、中性粒细胞计数(NEU)、单核细胞计数(MON)、活化部分凝血活酶时间(APTT)、乳酸(LAC)、氧合指数(OI)、急性生理学和慢性健康状况评估Ⅱ(APACHE Ⅱ)、序贯器官衰竭评分(SOFA)、SIRI比较,差异有统计学意义(P＜0.05).经多因素Logistic分析结果显示SIRI、APTT是脓毒症患者 28 天死亡的独立危险因素.ROC曲线分析结果显示SIRI、APTT预测脓毒症患者预后的曲线下面积分别为 0.747、0.644,二者联合曲线下面积为 0.807.生存分析显示SIRI＞17.1×109/L的患者28d生存率随时间延长下降.结论 SIRI有助于早期对脓毒症患者进行预后评估.
Abstract
Objective To investigate the predictive value of the systemic inflammatory response index(SIRI)for sepsis patients'28-day mortality.Methods Clinical data of 150 sepsis patients admitted to the central ICU,emergency ICU and trauma ICU of the First Affiliated Hospital of Hainan Medical College from July 2019 to December 2022 were retrospectively analyzed.The SIRI was calculated.The patients were divided into a survival group and a death group according to the 28-day mortality.The clinical data were compared between the two groups.Multifactorial analysis was performed using the stepwise regression method,and the receiver operating characteristic curves(ROCs)were plotted.The predictive value of SIRI for sepsis prognosis was analyzed.Kaplan-Meier survival curves were plotted based on the cutoff values determined from the ROC curves.Results There were significant differences in white blood cell counts(WBC),neutrophil counts(NEU),monocyte counts(MON),activated partial thromboplastin time(APTT),lactate(LAC),oxygenation index(OI),acute physiology and chronic health assessment Ⅱ(APACHE Ⅱ)and sequential organ failure score(SOFA)and SIRI between the survival group and the death group(P＜0.05).The results of multifactorial logistic analysis showed that SIRI and APTT were independent risk factors for 28-day deaths in patients with sepsis.The results of ROC curve analysis showed that the areas under the curve of SIRI and APTT predicting the prognosis of patients with sepsis were 0.747 and 0.644,respec-tively,and the area under the curve of the combination of the two was 0.807.Survival analysis showed that the 28-day survival rate of patients with SIRI＞17.1×109/L was decreased with time.Conclusions SIRI helps in early prognostic assessment of sepsis patients.
关键词
脓毒症/全身炎症反应指数/预后Key words
Sepsis/Systemic inflammation response index/Prognosis引用本文复制引用
基金项目
中国医学科学院医学与健康科技创新工程项目(2019-12M-5-023)
四川省科技基金(2022YFS0602)
海南省重点科技专项(ZDKJ202004)
海南省重点科技专项(ZDKJ2021038)
出版年
2024
NETL
NSTL
万方数据