首页|乳酸/白蛋白和C反应蛋白对脓毒症患者90d死亡风险的预测价值

乳酸/白蛋白和C反应蛋白对脓毒症患者90d死亡风险的预测价值

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原文链接
  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
目的 探讨乳酸/白蛋白(lactate/albumin,L/A)和C反应蛋白(C-reactive protein,CRP)对脓毒症患者90d死亡风险的预测价值.方法 回顾性选取2021年2月至2024年2月金华市人民医院综合重症医学科125例确诊为脓毒症患者的临床资料,根据患者90d是否死亡分为死亡组(61例)和存活组(64例),通过多因素Logistic回归分析探讨脓毒症患者90d死亡的独立危险因素.绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析比较L/A、CRP及L/A联合CRP对脓毒症患者90d死亡的预测价值.同时根据最佳截断值对患者进行亚组分析,绘制Kaplan-Meier 生存曲线.结果 多因素 Logistic 回归分析显示,高 CRP(OR=1.009,95％CI:1.003～1.015,P=0.006)、高L/A(OR=1.449,95％CI:1.050～2.000,P=0.024)、并发急性肾损伤(OR=2.890,95％CI:1.198～6.975,P=0.018)是脓毒症患者90d死亡的独立危险因素.CRP、L/A及L/A联合CRP预测脓毒症患者90d死亡的曲线下面积(area under the curve,AUC)分别为0.645、0.612、0.708.亚组分析显示,L/A＞1.41组脓毒症患者90d病死率显著高于L/A≤1.41组(P=0.001),CRP＞93.29mg/L 组脓毒症患者 90d 病死率显著高于 CRP≤93.29mg/L 组(P=0.001),与 Kaplan-Meier 生存曲线分析结果一致.结论 L/A和CRP均对脓毒症患者90d预后有一定的预测价值,且两者联合预测效果更好.
Predictive value of lactate/albumin and C-reactive protein for 90-day mortality risk in patients with sepsis
Objective To investigate the predictive value of lactate/albumin(L/A)and C-reactive protein(CRP)for 90-day mortality risk in patients with sepsis.Methods Clinical data from 125 patients diagnosed with sepsis in the Comprehensive Intensive Care Unit,Jinhua People's Hospital from February 2021 to February 2024 retrospectively were collected.According to 90-day death or not of patients,they were divided into death group(n=61)and survival group(n=64).Independent risk factors for 90-day mortality in patients with sepsis were analyzed by using multivariate Logistic regression.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of L/A,CRP,and L/A combined CRP for 90-day mortality in patients with sepsis.At the same time,subgroup analysis of patients was performed according to the best cut-off value,and Kaplan-Meier survival curves were drawn.Results Multivariate Logistic regression analysis showed that high CRP(OR=1.009,95％CI:1.003-1.015,P=0.006),high L/A(OR=1.449,95％CI:1.050-2.000,P=0.024),and concurrent acute kidney injury(OR=2.890,95％CI:1.198-6.975,P=0.018)were independent risk factors for 90-day mortality in patients with sepsis.Area under the curve(AUC)for predicting 90-day mortality in patients with sepsis by using CRP,L/A,and L/A combined with CRP were 0.645,0.612 and 0.708 respectively.Subgroup analysis showed that 90-day mortality of patients with sepsis in L/A＞1.41 group was significantly higher than that in L/A≤1.41 group(P=0.001),and 90-day mortality of patients with sepsis in CRP＞93.29mg/L group was significantly higher than that in CRP≤93.29mg/L group(P=0.001),which was consistent with the analysis results of Kaplan-Meier survival curve.Conclusion Both L/A and CRP have certain predictive value for 90-day prognosis of patients with sepsis,and their combined predictive effect is better.

Lactate/albuminC-reactive proteinSepsisMortality riskPredictive value

杜晓露、詹亚胜、项美姣

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金华市人民医院综合重症医学科,浙江金华 321000

乳酸/白蛋白 C反应蛋白 脓毒症 死亡风险 预测价值

浙江省金华市科学技术研究计划项目

2021-4-070

2024

10.3969/j.issn.1673-9701.2024.27.001

中国现代医生
中国医学科学院

中国现代医生

影响因子：1.571
ISSN：1673-9701
年,卷(期)：2024.62(27)