阴离子间隙对判断重症肺结核预后的作用  

Role of anion gap in prognosing the outcome of severe tuberculosis

作　　者：张瀚文 陈效友[2] ZHANG Han-wen;CHEN Xiao-you(Heilongjiang Provincial Institute of Infectious Disease Prevention and Control,Harbin,Heilongjiang 150599,China;Beijing Chest Hospital Affiliated to Capital Medical University,Beijing 101149,China)

机构地区：[1]黑龙江省传染病防治院,黑龙江哈尔滨150599 [2]首都医科大学附属北京胸科医院结核三科,北京101149

出　　处：《临床肺科杂志》2023年第1期11-15,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨血清阴离子间隙(AG)与重症肺结核患者预后的关系。方法回顾性分析本院ICU 2020年1月至2020年12月收治的重症肺结核患者的病例资料,换算出阴离子间隙数值,进行APACHEII评分,记录患者是否死亡。应用统计学方法分析阴离子间隙(AG)与重症肺结核患者预后的关系。结果本研究共有100名重症肺结核患者符合入选标准,按照治疗效果,分为生存组(n=85)以及死亡组(n=15)。实验室指标中,WBC、Hb、ESR、CRP、Alb及AG在两组间均有明显差异(P<0.05),且AG与WBC、Alb、ESR及CRP呈正相关(P<0.05),与Hb及Alb呈负相关。研究结果显示,AG与APACHEII评分呈正相关,AG及APACHEII评分与重症肺结核患者预后具有相关性(P<0.05);绘制AG、APACHEII评分与患者预后的ROC曲线,其AUC值分别为0.992、0.936,两者联合的AUC值为0.998。结论AG能够在一定程度上预测重症肺结核患者的预后。AG联合APACHEII评分,可以更好的预测重症肺结核病人的预后。Objective To discuss the relationship between serum anionic gap(AG)and prognosis in patients with severe tuberculosis.Methods The clinical data of severe tuberculosis patients admitted to the intensive care unit from January to December 2020 were retrospectively analyzed.The anionic gap value was calculated,they were given APACHE II scoring,and then the prognosis of patients was recorded.The relationship between AG and prognosis in patients with severe tuberculosis was analyzed by statistical methods.Results A total of 100 patients with severe tuberculosis were enrolled in this study,which was divided into the survivors group(n=85)and the death group(n=15)according to the therapeutic effect.WBC,Hb,ESR,CRP,Alb as well as AG in laboratory index were significant different between the two groups(P<0.05).AG was correlated with WBC,Alb,ESR and CRP(P<0.05),but it was negatively correlated with Hb and Alb.The results showed that AG was positively correlated with APACHE II score,and both were correlated with prognosis of patients with severe pulmonary tuberculosis(P<0.05).By plotting ROC curves of AG and APACHE II scores for predicting prognostic of patients,the AUC values of AG and APACHE II scores respectively were 0.992 and 0.936,and the combined AUC value of both was 0.998.Conclusion AG can predict the prognosis of patients with severe tuberculosis in some extent.Adding AG to APACHE II score can better predict the prognosis of patients with severe tuberculosis.

关 键 词：重症肺结核 阴离子间隙 判断预后 

分 类 号：R521[医药卫生—内科学]