The role of C-reactive protein to prealbumin ratio for diagnosis and prognosis evaluation of sepsis
扫码查看
点击上方二维码区域，可以放大扫码查看
原文链接
万方数据
目的 探讨C反应蛋白（CRP）与前白蛋白（PA）比值在脓毒症诊断和预后评估中的应用价值。 方法 采用回顾性研究的方法，选取2021年9月至2022年9月东营市人民医院收治的95例脓毒症患者（脓毒症组）和100例局部感染患者（非脓毒症组）为研究对象。脓毒症患者按照28 d转归分为存活组（57例）和死亡组（38例）。收集患者临床资料，计算CRP/PA比值；应用多因素Logistic回归和Cox回归分析各指标与脓毒症发生及预后的关系，绘制受试者工作特征（ROC）曲线评价CRP/PA比值对脓毒症发生和预后的预测价值，应用Kaplan-Meier生存曲线评价不同CRP/PA比值患者的生存率。 结果 脓毒症组收缩压、舒张压、PA低于非脓毒症组[（117.27 ± 11.65）mmHg（1 mmHg = 0.133 kPa）比（123.26 ± 10.71）mmHg、（69.42 ± 8.58）mmHg比（75.44 ± 6.53）mmHg、（174.09 ± 24.77）g/L比（207.13 ± 34.31）g/L]，心率、呼吸频率、CRP、CRP/PA比值、降钙素原高于非脓毒症组[（97.87 ± 12.73）次/min比（86.90 ± 10.19）次/min、22.00（20.00，25.00）次/min比21.00（19.00，23.00）次/min、（93.96 ± 19.64）mg/L比（77.56 ± 22.54）mg/L、0.54（0.44，0.65）比0.37（0.28，0.46）、3.35（2.16，4.17）μg/L比1.52（0.81，2.16）μg/L]，差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，CRP/PA比值、降钙素原是脓毒症的危险因素（P<0.05）。ROC曲线分析结果显示，CRP/PA比值诊断脓毒症的曲线下面积（AUC）为0.821，特异度为76.0%，灵敏度为93.7%。存活组舒张压、PA、中性粒细胞计数高于死亡组[（71.76 ± 8.86）mmHg比（67.86 ± 8.10）mmHg、（181.46 ± 24.35）g/L比（163.05 ± 21.28）g/L、（63.46 ± 9.88）× 109/L比（57.13 ± 8.64）× 109/L]，心率、呼吸频率、CRP、CRP/PA比值、淋巴细胞计数、降钙素原低于死亡组[（95.68 ± 13.48）次/min比（101.16 ± 10.88）次/min、22.00（19.50，24.00）次/min比24.00（20.00，28.00）次/min、（88.09 ± 19.35）mg/L比（102.76 ± 16.75）mg/L、0.46（0.41，0.58）比0.63（0.55，0.72）、21.00（16.00，30.00）×109/L比29.50（18.00，37.30）×109/L、2.94（2.10，3.97）μg/L比3.82（2.21，4.77）μg/L]，差异有统计学意义（P<0.05）。多因素Cox回归分析结果显示，CRP/PA比值、降钙素原是脓毒症预后的独立危险因素（P<0.05）。CRP/PA比值预测脓毒症预后的AUC为0.827，特异度为92.1%，灵敏度为63.8%。以CRP/PA比值最佳临界值（0.48）分组，CRP/PA>0.48组患者28 d病死率高于CRP/PA≤0.48组，差异有统计学意义（P<0.01）。 结论 CRP/PA比值可作为脓毒症诊断和评估预后的指标。 Objective To explore the application of C-reactive protein(CRP) to prealbumin (PA) ratio(CRP/PA) for diagnosis and prognosis evaluation of sepsis. Methods By a retrospective study, a total of 95 sepsis patients (sepsis group) and 100 local infection patients(non-sepsis group) treated in Dongying People′s Hospital from September 2021 to September 2022 were enrolled. Sepsis patients were divided into survival group(57 cases) and death group (38 cases) according to the 28-day outcome. The clinical data were collected and CRP/PA was calculated. Multivariate Logistic regression and Cox regression were used to analyze the relationship between various indicators and the occurrence and prognosis of sepsis, and receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic and prognostic value of CRP/PA for sepsis. Kaplan-Meier survival analysis was used to evaluate the prognostic value of different CRP/PA ratios for patients with sepsis. Results The systolic blood pressure, diastolic blood pressure, prealbumin were lower and heart rate, respiratory rate, CRP, CRP/PA, procalcitonin were higher in the sepsis group compared to the non-sepsis group: (117.27 ± 11.65) mmHg (1 mmHg = 0.133 kPa) vs. (123.26 ± 10.71) mmHg, (69.42 ± 8.58) mmHg vs. (75.44 ± 6.53) mmHg, (174.09 ± 24.77) g/L vs. (207.13 ± 34.31) g/L, (97.87 ± 12.73) bpm vs. (86.90 ± 10.19) bpm, 22.0(20.00, 25.00) times/min vs. 21.00(19.00, 23.00) times/min, (93.96 ± 19.64) mg/L vs. (77.56 ± 22.54) mg/L, 0.54(0.44, 0.65) vs. 0.37(0.28, 0.46), 3.35(2.16, 4.17) μg/L vs. 1.52(0.81, 2.16) μg/L, there were statistical differences ( P<0.05). Multivariate Logistic regression analysis showed that CRP/PA and procalcitonin were risk factors for sepsis (P<0.05). The results of ROC curve showed that the area under the curve (AUC) of CRP/PA in diagnosis of sepsis was 0.821, the specificity and sensitivity was 76.0% and 93.7%, respectively. The diastolic blood pressure, prealbumin, neutrophil were higher and the heart rate, respiratory rate, CRP, CRP/PA, lymphocytes, procalcitonin were lower in the survival group compared to the death group: (71.76 ± 8.86) mmHg vs. (67.86 ± 8.10) mmHg, (181.46 ± 24.35) g/L vs. (163.05 ± 21.28) g/L, (63.46 ± 9.88) × 109/L vs.(57.13 ± 8.64) × 109/L, (95.68 ± 13.48) times/min vs. (101.16 ± 10.88) times/min, 22.00(19.50, 24.00) times/min vs. 24.00(20.00, 28.00) times/min, (88.09 ± 19.35) mg/L vs. (102.76 ± 16.75) mg/L, 0.46(0.41, 0.58) vs. 0.63(0.55, 0.72), 21.00(16.00, 30.00) ×109/L vs. 29.50(18.00, 37.30) ×109/L, 2.94(2.10, 3.97) μg/L vs. 3.82(2.21, 4.77) μg/L, there were statistical differences ( P<0.05). Multivariate Cox regression analysis showed that CRP/PA and procalcitonin were independent risk factors for the prognosis of sepsis (P<0.05). The AUC of CRP/PA in predicting the prognosis of sepsis was 0.827, the specificity and sensitivity was 92.1% and 63.8%, respectively. Grouped by the cut-off of CRP/PA (0.48), the 28-day mortality rate of patients in the CRP/PA>0.48 was significantly higher than that of patients in the CRP/PA≤0.48, there was statistical difference (P<0.01). Conclusions CRP/PA ratio can be used as an index for diagnosis and prognosis evaluation of sepsis.
Objective To explore the application of C-reactive protein(CRP) to prealbumin (PA) ratio(CRP/PA) for diagnosis and prognosis evaluation of sepsis. Methods By a retrospective study, a total of 95 sepsis patients (sepsis group) and 100 local infection patients(non-sepsis group) treated in Dongying People′s Hospital from September 2021 to September 2022 were enrolled. Sepsis patients were divided into survival group(57 cases) and death group (38 cases) according to the 28-day outcome. The clinical data were collected and CRP/PA was calculated. Multivariate Logistic regression and Cox regression were used to analyze the relationship between various indicators and the occurrence and prognosis of sepsis, and receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic and prognostic value of CRP/PA for sepsis. Kaplan-Meier survival analysis was used to evaluate the prognostic value of different CRP/PA ratios for patients with sepsis. Results The systolic blood pressure, diastolic blood pressure, prealbumin were lower and heart rate, respiratory rate, CRP, CRP/PA, procalcitonin were higher in the sepsis group compared to the non-sepsis group: (117.27 ± 11.65) mmHg (1 mmHg = 0.133 kPa) vs. (123.26 ± 10.71) mmHg, (69.42 ± 8.58) mmHg vs. (75.44 ± 6.53) mmHg, (174.09 ± 24.77) g/L vs. (207.13 ± 34.31) g/L, (97.87 ± 12.73) bpm vs. (86.90 ± 10.19) bpm, 22.0(20.00, 25.00) times/min vs. 21.00(19.00, 23.00) times/min, (93.96 ± 19.64) mg/L vs. (77.56 ± 22.54) mg/L, 0.54(0.44, 0.65) vs. 0.37(0.28, 0.46), 3.35(2.16, 4.17) μg/L vs. 1.52(0.81, 2.16) μg/L, there were statistical differences ( P<0.05). Multivariate Logistic regression analysis showed that CRP/PA and procalcitonin were risk factors for sepsis (P<0.05). The results of ROC curve showed that the area under the curve (AUC) of CRP/PA in diagnosis of sepsis was 0.821, the specificity and sensitivity was 76.0% and 93.7%, respectively. The diastolic blood pressure, prealbumin, neutrophil were higher and the heart rate, respiratory rate, CRP, CRP/PA, lymphocytes, procalcitonin were lower in the survival group compared to the death group: (71.76 ± 8.86) mmHg vs. (67.86 ± 8.10) mmHg, (181.46 ± 24.35) g/L vs. (163.05 ± 21.28) g/L, (63.46 ± 9.88) × 109/L vs.(57.13 ± 8.64) × 109/L, (95.68 ± 13.48) times/min vs. (101.16 ± 10.88) times/min, 22.00(19.50, 24.00) times/min vs. 24.00(20.00, 28.00) times/min, (88.09 ± 19.35) mg/L vs. (102.76 ± 16.75) mg/L, 0.46(0.41, 0.58) vs. 0.63(0.55, 0.72), 21.00(16.00, 30.00) ×109/L vs. 29.50(18.00, 37.30) ×109/L, 2.94(2.10, 3.97) μg/L vs. 3.82(2.21, 4.77) μg/L, there were statistical differences ( P<0.05). Multivariate Cox regression analysis showed that CRP/PA and procalcitonin were independent risk factors for the prognosis of sepsis (P<0.05). The AUC of CRP/PA in predicting the prognosis of sepsis was 0.827, the specificity and sensitivity was 92.1% and 63.8%, respectively. Grouped by the cut-off of CRP/PA (0.48), the 28-day mortality rate of patients in the CRP/PA>0.48 was significantly higher than that of patients in the CRP/PA≤0.48, there was statistical difference (P<0.01). Conclusions CRP/PA ratio can be used as an index for diagnosis and prognosis evaluation of sepsis.
万方数据
