白蛋白/纤维蛋白原比值联合营养评分对创伤失血性休克患者预后的评估价值研究  

Study on the evaluative value of albumin/fibrinogen ratio combined with nutritional scores in predicting the prognosis of patients with traumatic hemorrhagic shock

作　　者：宋琦 徐志鹏 邵志林 达瓦卓玛 窦贺贺 郑传明 邱兆磊 李磊 SONG Qi;XU Zhipeng;SHAO Zhilin;DAWA Zhuoma;DOU Hehe;ZHENG Chuanming;QIU Zhaolei;LI Lei(The First Affiliated Hospital of Bengbu Medical University,Bengbu 233000,Anhui,China;Shannan People’s Hospital,Shannan 856000,Xizang Autonomous Region,China)

机构地区：[1]蚌埠医科大学第一附属医院,安徽蚌埠233000 [2]西藏自治区山南市人民医院,西藏山南856000

出　　处：《右江民族医学院学报》2024年第5期681-685,共5页Journal of Youjiang Medical University for Nationalities

基　　金：安徽省教育厅自然科学重点项目(2022AH051478);蚌埠医学院自然科学重点项目(2022byzd064)。

摘　　要：目的探讨早期ISS评分、AFR、HBP、PNI和CONUT评分等指标对创伤失血性休克患者预后的评估价值。方法采用回顾性分析的方法,将2020年1月至2022年12月蚌埠医科大学第一附属医院急诊外科收治的66例创伤失血性休克患者纳入研究。根据预后情况分为预后良好组(n=39)和预后不良组(n=27)。收集患者的一般资料和实验室检查结果,计算AFR、PNI和CONUT评分,同时记录ISS评分。比较两组各项指标的差异,绘制ROC曲线,评估各项指标对患者预后的预测价值,通过二元Logistic回归分析患者预后的影响因素。结果与预后良好组相比,预后不良组患者ISS评分高、AFR及PNI低、CONUT评分高(P<0.05);两者的HBP差异无统计学意义(P>0.05)。Logistic回归分析提示,ISS评分(OR=1.321,95%CI:1.070~1.630,P=0.010)、AFR(OR=0.168,95%CI:0.037~0.768,P=0.021)、PNI(OR=0.719,95%CI:0.531~0.974,P=0.033)、CONUT评分(OR=3.314,95%CI:1.395~7.875,P=0.007)是影响患者预后的因素。ISS评分、AFR、PNI和CONUT评分预测患者预后不良的最佳截断值分别为21.500分、8.925分、47.500分、3.500分,对应的AUC分别为0.720、0.852、0.733、0.874。结论ISS评分、AFR、PNI和CONUT评分这些指标对创伤失血性休克患者的预后有一定的预测价值。Objective To investigate the evaluative value of early Injury Severity Score(ISS),Albumin/Fibrinogen Ratio(AFR),Heparin-Binding Protein(HBP),Prognostic Nutritional Index(PNI),and Controlling Nutritional Status(CONUT)score in predicting the prognosis of patients with traumatic hemorrhagic shock.Methods A retrospective analysis was conducted on 66 patients with traumatic hemorrhagic shock admitted to the Emergency Surgery Department of the First Affiliated Hospital of Bengbu Medical University from January 2020 to December 2022.The patients were divided into a good prognosis group(n=39)and a poor prognosis group(n=27)based on their prognosis.General information and laboratory test results were collected from the patients to calculate AFR,PNI,and CONUT scores,while ISS scores were also recorded.Differences in various indicators between the two groups were compared,and ROC curves were plotted to assess the predictive value of each indicator for the prognosis of patients.Binary Logistic regression analysis was performed to identify factors influencing patient prognosis.Results Compared with the good prognosis group,patients in the poor prognosis group had higher ISS scores,lower AFR and PNI values,and higher CONUT scores(P<0.05),there was no statistically significant difference in HBP between the two groups(P>0.05).Logistic regression analysis indicated that ISS scores(OR=1.321,95%CI:1.070~1.630,P=0.010),AFR(OR=0.168,95%CI:0.037~0.768,P=0.021),PNI(OR=0.719,95%CI:0.531~0.974,P=0.033),and CONUT score(OR=3.314,95%CI:1.395~7.875,P=0.007)were factors influencing patient prognosis.The optimal cutoff values for ISS score,AFR,PNI,and CONUT score in predicting poor prognosis were 21.500,8.925,47.500,and 3.500,respectively,with corresponding AUCs of 0.720,0.852,0.733,and 0.874.Conclusion The indicators of ISS score,AFR,PNI,and CONUT score have certain predictive value for the prognosis of patients with traumatic hemorrhagic shock.

关 键 词：白蛋白/纤维蛋白原比值 预后营养指数 营养控制状态评分 休克 创伤性 

分 类 号：R605.971[医药卫生—急诊医学]