营养风险指数在肝脓肿患者预后评估中的价值  

The value of nutritional risk index in prognosis evaluation of patients with liver abscess

作　　者：冯静云[1] 徐尧[1] 陈菲菲[1] FENG Jingyun;XU Yao;CHEN Feifei(Intensive Care Unit of the Third People's Hospital of Changzhou,213000 Changzhou,Jiangsu)

机构地区：[1]常州市第三人民医院重症监护室,江苏常州213000

出　　处：《包头医学院学报》2023年第4期51-55,80,共6页Journal of Baotou Medical College

摘　　要：目的:探讨营养风险指数(nutritional risk index,NRI)与肝脓肿(PLA)患者预后不良结局之间的关系,并评估NRI的预后预测价值。方法:选取2016年6月至2021年12月期间就诊的PLA患者90例,根据NRI临界值83.5分,分为NRI<83.5组(n=44例)和NRI≥83.5组(n=46例),比较两组患者间的人口统计学资料、临床资料以及临床治疗效果,并利用Logistic回归分析模型和受试者操作特征(ROC)曲线对预后评估价值进行分析。结果:与NRI≥83.5组PLA患者相比,NRI<83.5组患者的转移性感染(25.00%vs 6.52%)、急性肝衰竭(9.09%vs 0.00%)、急性呼吸衰竭(13.64%vs 2.17%)、上消化道出血(13.64%vs 2.17%)、肺部感染(20.45%vs 6.52%)、预后不良(45.45%vs 19.57%)和病死率(13.64%vs 2.17%)的风险明显更高(P<0.05)。多元Logistic回归分析显示,年龄(HR=2.519,95%CI=1.106-5.739)、BMI(HR=0.708,95%CI=0.519-0.967)、PLT(HR=0.464,95%CI=0.254-0.848)、TBil(HR=2.387,95%CI=1.131-5.037)、PT(HR=2.201,95%CI=1.076-4.501)和NRI(<83.5分)(HR=3.377,95%CI=1.471-7.753)是PLA患者预后不良的独立预测因子(P<0.05)。NRI预测PLA患者预后不良的ROC曲线下面积(AUC)=0.799,临界值=87.65。结论:NRI水平较低是PLA预后不良的独立危险因素。Objective:To explore the relationship between nutritional risk index(NRI)and poor prognosis of patients with liver abscess(PLA),and to evaluate the prognostic value of NRI.Methods:90 PLA patients were selected from June 2016 to December 2021,and were divided into NRI<83.5 group(n=44 cases)and NRI≥83.5 group(n=46 cases)according to the NRI threshold score of 83.5.The demographic data,clinical data and clinical treatment effect between the two groups were compared,and the prognostic evaluation value was analyzed using Logistic regression analysis model and subject operating characteristic(ROC)curve.Results:Compared with PLA patients in NRI≥83.5 group,the risk of metastatic infection(25.00%vs 6.52%),acute liver failure(9.09%vs 0.00%),acute respiratory failure(13.64%vs 2.17%),upper gastrointestinal bleeding(13.64%vs 2.17%),lung infection(20.45%vs 6.52%),poor prognosis(45.45%vs 19.57%)and mortality(13.64%vs 2.17%)in NRI<83.5 group were significantly higher(P<0.05).Multiple logistic regression analysis showed that age(HR=2.519,95%CI=1.106-5.739),BMI(HR=0.708,95%CI=0.519-0.967),PLT(HR=0.464,95%CI=0.254-0.848),TBil(HR=2.387,95%CI=1.131-5.037),PT(HR=2.201,95%CI=1.076-4.501)and NRI(<83.5 points)(HR=3.377,95%CI=1.471-7.753)were independent predictors of poor prognosis in patients with PLA(P<0.05).The area under the ROC curve(AUC)of NRI predicting poor prognosis in patients with PLA=0.799,and the critical value=87.65.Conclusion:The low level of NRI is an independent risk factor for poor prognosis of PLA.

关 键 词：营养风险指数 肝脓肿 预后不良 预测价值 

分 类 号：R575.4[医药卫生—消化系统] R459.3[医药卫生—内科学]