尿素氮与白蛋白比值对重症肺炎预后的评估价值  

Value of the ratio of urea nitrogen to albumin in evaluating the prognosis of severe pneumonia

作　　者：陈云[1] 周云云 古利明[1] CHEN Yun;ZHOU Yunyun;GU Liming(Department of Critical Care Medicine,the Sixth Affiliated Hospital of Kunming Medical Uni-versity,Yuxi,Yunnan,653100,China)

机构地区：[1]昆明医科大学第六附属医院重症医学科,云南玉溪653100

出　　处：《临床急诊杂志》2020年第10期815-818,共4页Journal of Clinical Emergency

摘　　要：目的:探讨尿素氮/白蛋白比值(B/A)对于重症肺炎预后的判断价值。方法:回顾性收集2018-01—2019-12期间入住我院重症医学科的重症肺炎患者共110例。按临床结局将患者分为存活组(62例)和死亡组(48例),收集并分析两组患者的相关临床资料。结果:(1)与存活组相比,重症肺炎死亡组患者在APACHEⅡ评分、SOFA评分、白细胞、尿素氮、B/A显著高于存活组,氧合指数、白蛋白显著低于存活组,两组间各指标差异均具有统计学意义(P<0.05);(2)多因素Logistic回归分析显示B/A是重症肺炎不良预后的独立危险因素,B/A受试者工作特征曲线(ROC)的曲线下面积为0.72,诊断最佳截点值为10.44,诊断敏感度为68.8%,特异度为67.7%。结论:B/A比值是重症肺炎患者不良预后的独立危险因素,可作为判断重症肺炎患者预后的评价指标。Objective:To explore the prognostic value of urea nitrogen/albumin ratio(B/A)in patients with severe pneumonia.Method:A total of 110 patients with severe pneumonia admitted to the Department of Critical Care Medicine of our hospital from January 2018 to December 2019 were collected retrospectively.According to the clinical outcome,the patients were divided into survival group(n=62)and death group(n=48).The relevant clinical data of the two groups were collected and analyzed.Result:(1)Compared with the survival group,the APACHEⅡscore,SOFA score,white blood cell,urea nitrogen and B/A in the death group of severe pneumonia were significantly higher than those in the survival group,while the oxygenation index and albumin were significantly lower than those in the survival group.There were significant differences in all indexes between the two groups(P<0.05).(2)Multivariate Logistic regression analysis showed that B/A was an independent risk factor for poor prognosis of severe pneumonia.The area under the working characteristic curve(ROC)was 0.72,the best cut-off point for diagnosis was 10.44,the diagnostic sensitivity was 68.8%,and the specificity was 67.7%.Conclusion:The ratio of B/A is an independent risk factor for poor prognosis in patients with severe pneumonia and can be used as an index to evaluate the prognosis of patients with severe pneumonia.

关 键 词：白蛋白 尿素氮 重症肺炎 预后 

分 类 号：R563.1[医药卫生—呼吸系统]