尿酸与白蛋白比值在预测重症恙虫病中的价值  

Value of Uric Acid to Albumin Ratio in Predicting Severe Tsutsugamushi Disease

作　　者：李梅[1] 许汪斌[1] 王雨平[1] 王飞[1] 代冬梅[1] LI Mei;XU Wang-bin;WANG Yu-ping;WANG Fei;DAI Dong-mei(Dept.of Critical Care Medicine,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032,China)

机构地区：[1]昆明医科大学第一附属医院重症医学科,云南昆明650032

出　　处：《昆明医科大学学报》2020年第3期62-66,共5页Journal of Kunming Medical University

基　　金：云南省重大科技专项计划-生物医药重大专项基金资助项目(2018ZF009)。

摘　　要：目的探究尿酸与白蛋白比值在诊断重症恙虫病的价值,为临床提供一个快捷有效的方法。方法采用病例报告表(CRF)收集2017年1月1日至2018年12月31日云南省各家医院收治的581例恙虫病患者的临床资料,根据重症恙虫病诊断标准将其分为非重症组401例和重症组180例,对比分析两组患者的年龄、性别、白蛋白(ALB)、尿酸(UA)、尿酸与白蛋白比值的差异并绘制ROC曲线。结果(1)两组基本情况比较:非重症组和重症组的性别构成无统计学差异(P>0.05);与非重症组相比,重症组年龄增高(岁:54.20±14.80比45.39±16.78,P<0.05);(2)与非重症组比较,重症组UA、UA/ALB升高(P<0.05);(3)通过建立ROC曲线,可见曲线下面积(AUC)为0.800,表明UA/ALB比值鉴别诊断重症恙虫病的准确性较好,相应标准误为0.022,P<0.001,95%的可信区间为(0.757,0.843);(4)通过计算阳性似然比指数:确定选取UA/ALB比值为11.64,在该点的敏感度为57.8%,特异度为92.5%。结论UA/ALB对诊断重症恙虫病有预测价值。Objective To explore the value of uric acid to albumin ratio in the diagnosis of severe tsutsugamushi disease.Methods Case report form(CRF)was applied to collect the clinical data of 581 patients with severe tsutsugamushi disease admitted into hospitals in Yunnan province from January 1 st,2017 to December31 st,2018.Based on the diagnostic criteria of severe tsutsugamushi disease,the patients were divided into two groups:non-severe group(n=401)and severe group(n=180).Age,gender,albumin(ALB),uric acid(UA),uric acid to albumin ratio between the two groups were compared and ROC curve was drawn.Results(1)There was no significant difference in gender between the two groups(P>0.05).The mean age of the severe group was significantly higher than that of the non-severe group(54.20±14.80 vs.45.39±16.78,P<0.05).(2)UA and UA/ALB in the non-severe group were significantly higher than those in the severe group(P<0.05).(3)ROC curve exhibited that area under the curve(AUC)was 0.800,which indicated that the UA/ALB ratio was accurate in the differential diagnosis of severe tsutsuus disease,with standard error being 0.022,P<0.001 and 95%confidence interval(0.757,0.843).(4)Positive likelihood ratio index was calculated to determine UA/ALB ratio to be 11.64,with a sensitivity of 57.8%and specificity of 92.5%.Conclusion Uric acid to albumin ratio has predictive value in the diagnosis of severe tsutsugamushi disease.

关 键 词：尿酸 白蛋白 重症恙虫病 诊断 

分 类 号：R513.2[医药卫生—内科学]