ICU危重症患者血清CRP、ALB水平与APACHEⅡ评分的相关性及联合检测对预后的预测价值  

Correlation between Serum CRP and ALB Levels and APACHE Ⅱ Score in ICU Critically ill Patients and the Predictive Value of combined Detection for Prognosis

作　　者：徐静 罗彦[1] 黄建会 林丽群[1] Xu Jing;Luo Yan;Huang Jianhui;Lin Liqun(Departmet of critical medicine,Luzhou Hospital of Traditional Chinese Medicine,Luzhou 646000,Sichuan Province,China)

机构地区：[1]泸州市中医医院重症医学科,四川省泸州市646000

出　　处：《中国病案》2020年第4期109-112,共4页Chinese Medical Record

摘　　要：目的研究重症监护室危重症患者血清CRP、ALB水平与APACHEⅡ评分相关性及联合检测对预后的预测价值。方法选取2017年2月1日-2019年6月30日某院重症监护室危重症患者89例,预后良好组49例、预后不良组40例。入住重症监护室24小时(T1)、72小时(T2)内行血清血清CRP、ALB水平与APACHEⅡ评分并采用Pearson分析相关性,绘制受试者工作特征曲线ROC曲线明确各项指标及其联合预测重症监护室危重症患者预后价值。结果 (1)T1、T2各时刻,预后良好组CRP及APACHEⅡ评分低于预后不良组,ALB水平高于预后不良组(P<0.05);T2较T1时,预后良好组CRP及APACHEⅡ评分下降、ALB水平升高,预后不良组CRP及APACHEⅡ评分升高、ALB水平下降(P<0.05)。(2)血清CRP及APACHEⅡ评分呈正相关关系,血浆ALB水平与APACHEⅡ评分呈负相关关系,血清CRP水平与ALB水平呈负相关关系,均有P<0.05。(3)血清CRP、血浆ALB水平、APACHEⅡ评分预测ICU危重症患者预后ROC曲线下面积0.710、0.687、0.706。三指标联合应用的预测诊断效能较之单独应用时有明显提高,灵敏度和特异度分别为0.775 (31/40)、0.755 (37/49)。结论血清CRP、ALB水平与APACHEⅡ评分存在一定相关性,均能评定重症监护室危重症患者病情预后,但三种指标联合检测更具预测价值。Objective To study the correlation between serum CRP,ALB and APACHE Ⅱ score in critically ill patients in intensive care unit(ICU) and the predictive value of combined detection for prognosis.Methods 89 critically ill patients in ICU from February 1,2017 to June 30,2019 were selected.Among them,49 patients in good prognosis group and 40 patients in poor prognosis group.Serum CRP,plasma ALB level and APACHE Ⅱ score were measured at 24 h(T1) and 72 h(T2) in ICU.Pearson was used to analyze the correlation between CRP and ALB levels and APACHE Ⅱ scores,draw ROC curves,and determine the prognostic value of CRP,ALB levels,APACHE Ⅱ scores and their combination in ICU critically ill patients.Results(1) At each time of T1 and T2,the CRP level and APACHE Ⅱ score of patients with good prognosis were lower than those with poor prognosis,and the ALB level was higher than those with poor prognosis(P<0.05);when T2 was higher than T1,CRP levels and APACHE of good prognosis Ⅱ score decreased,ALB level increased,CRP level and APACHE Ⅱ score increased,ALB level decreased in the poor prognosis group(P<0.05).(2) There was a positive correlation between serum CRP levels and APACHE Ⅱ scores,a negative correlation between plasma ALB levels and APACHE Ⅱ scores,and a negative correlation between serum CRP levels and ALB levels,both P<0.05.(3) The serum CRP,plasma ALB levels,and APACHE Ⅱ scores predict the area under the ROC curve of ICU in critically ill patients of 0.710,0.687,and 0.706.The combined use of the three indicators has significantly improved the predictive diagnostic efficiency compared with the single application,with sensitivity and specificity of 0.775(31/40) and 0.755(37/49),respectively.Conclusion There is a correlation between serum CRP and ALB levels and APACHE Ⅱ scores,which can be used to evaluate the prognosis of critically ill patients with ICU.However,the combined detection of the three indicators has more predictive value.

关 键 词：重症监护室 C反应蛋白 白蛋白 急性生理功能和慢性健康状况评分系统Ⅱ 相关性 联合 预后 

分 类 号：R459.7[医药卫生—急诊医学]