PLR联合SOFA评分在老年脓毒症合并2019冠状病毒病患者中的预后评估价值  

Prognostic Evaluation Value of PLR and SOFA Score in Elderly Patients with Sepsis Combined with Corona Virus Disease 2019

作　　者：轩蕊蕊 马晓薇 韩佩佩 XUAN Ruirui;MA Xiaowei;HAN Peipei(Department of Critical Care Medicine,Cardiovascular and Cerebrovascular Disease Hospital,General Hospital of Ningxia Medical University,Yinchuan 750002,China;不详)

机构地区：[1]宁夏医科大学总医院心脑血管病医院重症医学科,宁夏银川750002

出　　处：《中国医学创新》2024年第36期133-137,共5页Medical Innovation of China

基　　金：宁夏回族自治区重点研发计划项目(2022BEG02045)。

摘　　要：目的:探讨血小板与淋巴细胞计数比值(PLR)联合序贯器官衰竭评估(SOFA)评分对老年脓毒症合并2019冠状病毒病(COVID-19)患者的预后评估价值。方法:收集2022年12月—2023年2月在宁夏医科大学总医院心脑血管病医院重症医学科住院的82例老年脓毒症合并COVID-19患者,根据28 d临床转归将患者分为存活组及死亡组。对两组临床指标、实验室指标、SOFA评分、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)、中性粒细胞与淋巴细胞比值(NLR)、PLR进行统计学分析,通过logistic回归分析老年脓毒症合并COVID-19患者28 d死亡的影响因素,并绘制受试者操作特征(ROC)曲线评估PLR及SOFA评分在预后评估中的价值。结果:82例患者中,28 d内存活38例,死亡44例。死亡组呼吸频率、SOFA评分、APACHEⅡ评分、NLR及PLR均高于存活组,淋巴细胞低于存活组,差异均有统计学意义(P<0.05)。logistic回归分析显示,APACHEⅡ、SOFA评分、PLR水平是老年脓毒症合并COVID-19患者28 d死亡的影响因素(P<0.05)。ROC曲线结果显示,PLR联合SOFA评分对老年脓毒症合并COVID-19患者28 d死亡的预测效能较高,AUC为0.891,敏感度为84.1%,特异度为81.6%。结论:SOFA评分、PLR水平是老年脓毒症合并COVID-19患者28 d死亡的影响因素,且PLR联合SOFA评分在老年脓毒症合并COVID-19患者28 d死亡中有较高的预测价值。Objective:To explore the prognostic value of platelet to lymphocyte count ratio(PLR)combined with sequential organ failure assessment(SOFA)score in elderly sepsis patients with COVID-19.Method:A total of 82 elderly patients with sepsis combined with COVID-19 hospitalized in Department of Critical Care Medicine,Cardiovascular and Cerebrovascular Disease Hospital,General Hospital of Ningxia Medical University from December 2022 to February 2023 were collected and divided into survival group and death group according to 28-day clinical outcomes.The clinical indicators,laboratory indicators,SOFA,acute physiology and chronic health evaluationⅡ(APACHEⅡ),neutrophil to lymphocyte ratio(NLR)and PLR of the two groups were statistically analyzed.logistic regression was used to analyze the PLR and SOFA score of 28-day death in elderly patients with sepsis combined with COVID-19,and receiver operating characteristics(ROC)curve was drawn to evaluate the value of PLR and SOFA score in prognostic assessment.Result:Of the 82 patients,38 survived and 44 died within 28 days.Respiratory rate,SOFA score,APACHEⅡ,NLR and PLR in death group were higher than those in survival group,and lymphocyte in death group was lower than that in survival group,the differences were statistically significant(P<0.05).logistic regression analysis showed that APACHEⅡ,SOFA scores and PLR level were influencing factors for 28-day death in elderly patients with sepsis combined with COVID-19(P<0.05).ROC curve results showed that PLR combined with SOFA score had high predictive efficacy for 28-day death in elderly patients with sepsis combined with COVID-19,and the AUC was 0.891,sensitivity was 84.1%,and specificity was 81.6%.Conclusion:SOFA score and PLR level are influencing factors for 28-day death in elderly patients with sepsis combined with COVID-19,and PLR combined with SOFA score has a high predictive value in 28-day death in elderly patients with sepsis combined with COVID-19.

关 键 词：脓毒症 2019冠状病毒病 血小板与淋巴细胞计数比值 序贯器官衰竭评估 预后 

分 类 号：R459.7[医药卫生—急诊医学] R511.9[医药卫生—治疗学]