前白蛋白、肝素结合蛋白联合SOFA评分对脓毒症患者预后的评估价值  

The evaluation value of prealbumin,heparin-binding protein combined with SOFA score in the prognosis of patients with sepsis

作　　者：杜晓红 谢海波 柴韩飞 DU Xiaohong;XIE Haibo;CHAI Hanfei(Department of Critical Medicine,Zhoushan Womenʼs and Childrenʼs Hospital,Zhejiang,Zhoushan 316000,China)

机构地区：[1]舟山市妇女儿童医院重症医学科,浙江舟山316000

出　　处：《中国现代医生》2022年第34期38-41,共4页China Modern Doctor

基　　金：舟山市科技计划项目(2021C31095)。

摘　　要：目的探讨前白蛋白、肝素结合蛋白联合序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分对脓毒症患者预后的评估价值。方法选取2019年4月至2022年4月于舟山市妇女儿童医院接受治疗的98例脓毒症患者,依据预后情况将其分为死亡组(n=35)和存活组(n=63),比较不同病情严重程度、不同预后患者的前白蛋白、肝素结合蛋白水平与SOFA评分情况,绘制受试者操作特征曲线(receiver operator characteristic curve,ROC曲线),比较各指标单独应用及联合应用在脓毒症患者预后评估中的应用价值。结果随着脓毒症病情的加重,患者的前白蛋白水平逐渐降低(P<0.05),肝素结合蛋白水平和SOFA评分逐渐升高(P<0.05);死亡组患者的前白蛋白水平显著低于存活组(P<0.05),肝素结合蛋白水平和SOFA评分均显著高于存活组(P<0.05);ROC曲线结果显示,前白蛋白、肝素结合蛋白、SOFA评分三者联合对脓毒症患者预后评估的价值最高,曲线下面积为0.931,敏感度和特异性分别为95.63%和98.35%。结论在脓毒症患者预后评估中,前白蛋白、肝素结合蛋白、SOFA评分有良好的预测价值。Objective To investigate the prognostic value of prealbumin, heparin-binding protein combined with sequential organ failure assessment(SOFA) score in patients with sepsis. Methods A total of 98 patients with sepsis who were treated in Zhoushan Women’s and Children’s Hospital from April 2019 to April 2022 were selected, according to the prognosis, they were divided into death group(n=35) and survival group(n=63). The levels of prealbumin, heparin-binding protein and SOFA score of patients with different disease severity and prognosis were compared. The receiver operator characteristic(ROC)curve was drawn to compare the application value of each indicator alone and in combination in the prognosis assessment of patients with sepsis. Results With the worsening of sepsis, the level of prealbumin decreased gradually(P<0.05), and the level of heparin-binding protein and SOFA score increased gradually(P<0.05). The prealbumin level in death group was significantly lower than that in survival group(P<0.05), and the heparin-binding protein level and SOFA score in death group were significantly higher than those in survival group(P<0.05). ROC curve results showed that the combination of prealbumin, heparin-binding protein and SOFA score had the highest prognostic value in patients with sepsis, with an area under the curve of 0.931, and a sensitivity and specificity of 95.63% and 98.35%, respectively. Conclusion Prealbumin and heparin-binding protein and SOFA score have good predictive value in the prognosis evaluation of sepsis patients.

关 键 词：前白蛋白 肝素结合蛋白 序贯器官衰竭评估 脓毒症 预后 

分 类 号：R459.7[医药卫生—急诊医学]