血清乳酸/血清白蛋白比值联合序贯性器官衰竭估计评分对脓毒症患者院内死亡的预测价值  

Value of the ratio of serum lactate to serum albumin combined with sequential organ failure assessment score in predicting inhospital death of patients with sepsis

作　　者：朱斌[1] 何许伟[2] 潘笑 ZHU Bin;HE Xuwei;PAN Xiao(Graduate School,Zhejiang Chinese Medical University,Hangzhou 310000,CHINA)

机构地区：[1]浙江中医药大学研究生院,浙江杭州310000 [2]丽水市人民医院急症科

出　　处：《江苏医药》2024年第9期909-912,共4页Jiangsu Medical Journal

基　　金：浙江省康恩贝医院管理软科学研究项目(2020ZHA-KE337)。

摘　　要：目的 探讨血清乳酸/血清白蛋白比值(LAR)联合序贯性器官衰竭估计(SOFA)评分对脓毒症患者院内死亡的预测价值。方法 根据30-d院内死亡,198例脓毒症患者分为A组(死亡,51例)和B组(好转,147例)。比较两组临床资料和实验室相关指标,分析脓毒症患者院内死亡的危险因素,分析LAR与SOFA评分的相关性,并绘制ROC曲线评估LAR和SOFA评分单独及联合应用对脓毒症患者院内死亡的预测效能。结果 与B组比较,A组年龄更大,且心率、呼吸频率、SOFA评分、BUN、SCr、降钙素原、血钾及LAR均较高,而体温和Plt较低(P<0.05或P<0.01)。年龄增大、LAR和SOFA评分升高是脓毒症患者院内死亡的独立危险因素(P<0.05或P<0.01)。脓毒症患者LAR与SOFA评分呈正相关(r=0.614,P<0.01)。LAR和SOFA联合预测脓毒症患者院内死亡的AUC为0.842,其灵敏度和特异度分别为82.4%和74.1%。结论 LAR联合SOFA评分对脓毒症患者院内死亡具有较高的预测价值。Objective e To explore the value of the ratio of serum lactate to serum albumin(LAR)combined with sequential organ failure assessment(SOFA)score in predicting inhospital death of the patients with sepsis.Methods According to the 30-day inhospital death,198 patients with sepsis were divided into two groups of A(inhospital death,51 cases)and B(survial and improved,147 cases).The clinical data and relevant laboratory indicators of the two groups were compared.The risk factors for inhospital death of the patients with sepsis were analyzed.The correlation between LAR and SOFA score was analyzed.ROC curve was drawn to evaluate the predictive efficacy of LAR and SOFA score alone and in combination for inhospital death of the patients with sepsis.Results Compared with group B,age was older,heart rate,respiration rate,SOFA score,BUN,SCr,procalcitonin,blood potassium and LAR were increased,while body temperature and Plt were decreased in group A(P<0.05 or P<0.01).Increased age,LAR and SOFA score were the independent risk factors for inhospital death of sepsis patients(P<0.05 or P<0.01).LAR was positively correlated with SOFA score in the patients with sepsis(r=0.614,P<O.O1).AUC of combined use of LAR and SOFA score in predicting inhospital death of the patients with sepsis was 0.842 with the sensitivity of 82.4%and the specificity of 74.1%,respectively.Conclusion LAR combined with SOFA score has a higher predictive value for inhospital death of the patients with sepsis.

关 键 词：血清乳酸/血清白蛋白比值 序贯性器官衰竭估计评分 脓毒症 

分 类 号：R631[医药卫生—外科学]