尿素对静脉血栓栓塞症患者预后不良的评估价值研究  

Value of Urea in evaluating the poor prognosis of patients with venous thromboembolism

作　　者：张海燕[1] 郭青青 周永梅 周湘红[1] 冉飞 ZHANG Haiyan;GUO Qingqing;ZHOU Yongmei;ZHOU Xianghong;RAN Fei(Department of Clinical Laboratory,Guizhou Provincial People′s Hospital,Guiyang,Guizhou 550002,China)

机构地区：[1]贵州省人民医院检验科,贵州贵阳550002

出　　处：《国际检验医学杂志》2023年第21期2626-2630,2635,共6页International Journal of Laboratory Medicine

基　　金：贵州省卫生健康委科学技术基金(gzwkj2022-177)。

摘　　要：目的分析尿素(Urea)对静脉血栓栓塞症患者预后不良的评估价值,为临床诊疗提供依据。方法收集2020年1-12月在该院住院治疗的静脉血栓栓塞症患者299例,记录其临床资料、实验室指标等数据,根据预后情况分为治愈组71例、好转组200例和未愈组28例。分析各组患者临床资料及实验室指标的差异,将有差异的指标进行Logistic回归分析预后不良的独立危险因素,采用受试者工作特征(ROC)曲线分析各指标对静脉血栓栓塞症患者预后不良的预测价值。结果3组患者在年龄、肿胀、糖尿病、凝血酶原时间(PT)、血小板计数(PLT)、淋巴细胞计数(LYM)、中性粒细胞计数(NEUT)、中性粒细胞与淋巴细胞比值(NLR)、Urea、肌酐(Cr)、肾小球滤过率估计值(eGFR)、胱抑素C(Cys-C)、尿酸(UA)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LD)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(HBDH)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(UBIL)、清蛋白(ALB)和白球比例(A/G)的差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示Urea(OR:1.36,95%CI:1.064~1.729)、LD(OR:1.004,95%CI:1.001~1.006)、HBDH(OR:1.002,95%CI:1.000~1.005)是静脉血栓栓塞症患者预后不良的独立危险因素(P<0.05)。ROC曲线分析发现,LD(AUC:0.657,95%CI:0.516~0.799)和HBDH(AUC:0.654,95%CI:0.516~0.792)对静脉血栓栓塞症患者预后不良的预测价值一般,而Urea(AUC:0.819,95%CI:0.723~0.916)具有较好的预测价值(P<0.01),其特异度为87.9%,灵敏度为64.0%,最佳截断值为8.13 U/L。结论LD、HBDH和Urea是静脉血栓栓塞症患者预后不良独立危险因素,且Urea对静脉血栓栓塞症患者预后不良具有较好的预测价值,可用于静脉血栓栓塞症的辅助诊疗和预后评估。Objective To analyze the evaluation value of Urea in the poor prognosis of patients with venous thromboembolism,and provide the basis for clinical diagnosis and treatment.Methods Collect 299 patients with venous thromboembolism who were hospitalized in the Guizhou Provincial People′s Hospital from January to December 2020,record their clinical data,laboratory indicators,and other data.According to the prognosis,they were divided into a cured group of 71 cases,an improved group of 200 cases,and an unhealed group of 28 cases.Analyze the differences in clinical data and laboratory indicators among each group of patients,and perform logistic regression analysis on independent risk factors for poor prognosis of different indicators.Use the receiver operating characteristic(ROC)curve to analyze the predictive value of each indicator for poor prognosis of venous thrombosis patients.Results In the three groups of patients,age,swelling,diabetes,Prothrombin time(PT),platelet count(PLT),lymphocyte count(LYM),neutrophil count(NEUT),neutrophil to lymphocyte ratio(NLR),Urea,creatinine(Cr),estimated glomerular filtration rate(eGFR),cystatin C(Cys-C),uric acid(UA),Asparagus cochinchinensis aminotransferase(AST),Lactate dehydrogenase(LD)Creatine kinase(CK),Creatine kinase Isozyme(CK-MB),α-Hydroxybutyrate Dehydrogenase(HBDH),total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(UBIL),the albumin(ALB)and globulin ratio(A/G)were statistically significant(P<0.05).Multivariate logistic regression analysis showed that Urea(OR:1.36,95%CI:1.060-1.730),LD(OR:1.004,95%CI:1.001-1.006)and HBDH(OR:1.002,95%CI:1.000-1.005)were independent risk factors for poor prognosis in patients with venous thrombosis(P<0.05).Multivariate logistic regression analysis showed that Urea(OR:1.36,95%CI:1.064-1.729),LD(OR:1.004,95%CI:1.001-1.006),and HBDH(OR:1.002,95%CI:1.000-1.005)were independent risk factors for poor prognosis in patients with venous thrombosis(P<0.05).ROC analysis found that LD(AUC:0.657,95%CI:0.516-0.799)and HBDH(AUC:0.654,95%CI

关 键 词：静脉血栓 预后不良 危险因素 

分 类 号：R543.6[医药卫生—心血管疾病] R446.1[医药卫生—内科学]