血清CysC、SAA联合APACHEⅡ评分对脓毒症合并急性肾损伤患者预后的评估价值  

Value of serum CysC and SAA combined with APACHEⅡscore in evaluating prognosis of patients with sepsis complicated with acute kidney injury

作　　者：纪小奇[1] 陈婷[1] 陈城[1] 王菁 姚莉[1] Ji Xiaoqi;Chen Ting;Chen Cheng(Department of Critical Care,Hefei Second People's Hospital,Hefei Hospital Affiliated to Anhui Medical University,Hefei 230000,China)

机构地区：[1]合肥市第二人民医院(安徽医科大学附属合肥医院)重症医学科,230000

出　　处：《中华保健医学杂志》2022年第2期125-127,共3页Chinese Journal of Health Care and Medicine

基　　金：安徽省蚌埠医学院科研项目(2020byzd293)。

摘　　要：目的探讨血清胱抑素C(CysC)、血清淀粉样蛋白A(SAA)联合急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分对脓毒症合并急性肾损伤(AKI)患者预后的评估价值。方法选取2017年8月~2020年8月合肥市第二人民医院收治的脓毒症合并AKI患者78例(AKI组),根据预后不同分为生存亚组42例和死亡亚组36例,另选取单纯脓毒症患者43例(非AKI组)。观察各组血清CysC、SAA水平及APACHEⅡ评分差异,绘制受试者工作特征曲线(ROC)测定各指标及联合检测对脓毒症合并AKI患者预后的评估价值。结果AKI组血清CysC、SAA水平及APACHEⅡ评分均高于非AKI组,差异有统计学意义(P<0.05);随着AKI分期增加,血清CysC、SAA水平及APACHEⅡ评分显著升高,差异有统计学意义(P<0.05)。死亡亚组患者血清CysC、SAA水平及APACHEⅡ评分明显高于生存亚组,差异有统计学意义(P<0.05)。ROC曲线显示,血清CysC、SAA联合APACHEⅡ评分对患者预后评估的AUC为0.923,预测灵敏度为80.6%,特异度为92.9%。结论血清CysC、SAA联合APACHEⅡ评分对评估脓毒症AKI患者预后具有较好参考价值,能够提高预后评估的准确性。Objective To investigate serum CysC and SAA combined with APACHEⅡscore for evaluating prognosis of patients with sepsis complicated with acute kidney injury(AKI).Methods 78 patients with sepsis complicated with AKI(AKI group)admitted to our hospital from August 2017 to August 2020 were selected,and were divided into survival subgroup(42 cases)and death subgroup(36 cases)according to prognosis,and 43 patients with simple sepsis(non-AKI group).The differences of serum CysC and SAA levels and APACHEⅡscore in each group were observed.The ROC curves were drawn to determine the evaluation value of each indicator and combined detection for the prognosis of patients with sepsis complicated with AKI.Results The levels of serum CysC,SAA and APACHEⅡscore in AKI group were higher than those in non-AKI group(P<0.05).With the increase of AKI stage,the levels of serum CysC,SAA and APACHEⅡscore were significantly increased(P<0.05).The levels of serum CysC,SAA and APACHEⅡscore in death subgroup were significantly higher than those in survival subgroup(P<0.05).ROC curve showed that the AUC of serum CysC and SAA combined with APACHEⅡscore was 0.923,the predictive sensitivity was 80.6%,and the specificity was 92.9%.Conclusions Serum CysC and SAA combined with APACHEⅡscore have good reference value for evaluating the prognosis of patients with septic AKI,and can improve the accuracy of prognosis assessment.

关 键 词：脓毒症 急性肾损伤 胱抑素C 血清淀粉样蛋白A 急性生理与慢性健康评分Ⅱ 

分 类 号：R541[医药卫生—心血管疾病]