NLR与CAR及联合指标对脓毒症患者28天死亡率的预测价值
Predictive value of neutrophil to lymphocyte ratio and C-reactive protein to albumin ratio for 28-day mortality in patients with sepsis
王博青 1王毅 1李志华 1于湘友1
作者信息
- 1. 新疆医科大学第一附属医院重症医学科,乌鲁木齐 830054
- 折叠
摘要
目的 探讨中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白与白蛋白比值(CAR)对脓毒症患者28d死亡率的预测价值.方法 采用回顾性分析方法,将2021年1月-2022年12月期间入住本院ICU的224例脓毒症患者作为研究对象.收集患者入院24h内的一般资料、临床检查指标,根据患者28d生存情况,将患者分为生存组和死亡组,对比两组间各指标的差异,并评价各指标对患者预后的判断价值.结果 存活组153例,死亡组71例.两组患者中性粒细胞计数、白蛋白、乳酸、APACHE-Ⅱ评分、CRP、NLR、CAR的差异均有统计学意义(P＜0.05或P＜0.001).NLR、CAR、APACHE-Ⅱ评分是导致脓毒症患28 d病死率增加的独立危险因素.NLR联合CAR用于评估脓毒症患者预后的AUC大于NLR、CAR单独应用,与APACHE-Ⅱ评分相当,而NLR、CAR与APACHE-Ⅱ评分三者联合的AUC大于两者联合.结论 NLR、CAR均对脓毒症患者的预后评估有一定的预测作用,而NLR联合CAR可以提高其预测价值.
Abstract
Objective To investigate the predictive value of neutrophil to lymphocyte ratio(NLR)and C-reactive protein to albu-min ratio(CAR)for 28-day mortality in patients with sepsis.Methods A retrospective analysis was performed on 224 patients with sepsis who were admitted to ICU in our hospital from January 2021 to December 2022.General data and clinical examination indicators of patients within 24 hours of admission were collected.According to the survival conditions of patients at 28 days,patients were di-vided into survival group and death group.The difference of various indicators between the two groups was compared,and the value of each indicator in judging the prognosis of patients was evaluated.Results 153 cases survived and 71 cases died.There were statisti-cally significant differences in neutrophil count,albumin,lactic acid,APACHE-Ⅱ score,CRP,NLR,and CAR between the two groups(P＜0.05 or P＜0.001).NLR,CAR,and APACHE-Ⅱ score were independent risk factors leading to increased mortality of 28 pa-tients with sepsis.The AUC of NLR combined with CAR for assessing the prognosis of sepsis patients was greater than that of NLR,CAR alone and was comparable to APACHE-Ⅱ score,while the AUC of the combination of NLR,CAR and APACHE-Ⅱ score was greater than that of the combination of both scores.Conclusion Both NLR and CAR can predict the prognosis of sepsis patients,and NLR combined with CAR can improve its predictive value.
关键词
脓毒症/中性粒细胞与淋巴细胞比值/C反应蛋白与白蛋白比值/28d死亡风险Key words
Sepsis/Neutrophil-to-lymphocyte ratio/C-reactive protein-albumin ratio/28-d mortality risk引用本文复制引用
基金项目
国家自然科学基金(82160360)
新疆维吾尔自治区科技支疆项目(2021E02064)
出版年
2024
NETL
NSTL
万方数据