SOFA评分联合血清IL-6、CRP及乳酸对重症肺炎28d预后的预测效能  

Predictive Efficacy of SOFA Score Combined with Serum IL-6,CRP and Lactate on 28-day Prognosis of Severe Pneumonia

作　　者：王淑 聂明 刘建敏[1] Wang Shu;Nie Ming;Liu Jianmin(Cardiac Intensive Care Unit,Anyang People's Hospital Anyang,Henan 455000,China)

机构地区：[1]安阳市人民医院,河南安阳455000

出　　处：《辽宁医学杂志》2024年第6期12-15,共4页Medical Journal of Liaoning

摘　　要：目的 探究序贯器官衰竭估计(SOFA)评分联合血清白细胞介素-6(IL-6)、C反应蛋白(CRP)及乳酸对重症肺炎28d预后的预测效能。方法 选取本院2020年到2023年98例重症肺炎患者,根据其28d后的死亡情况,分为生存组(n=60),死亡组(n=38),收集患者的一般资料,根据中文版的简化SOFA评分计算分数;在入院的次日空腹抽取5 ml静脉血和2 ml外周动脉血,采用酶联免疫吸附法检测血清IL-6、CRP水平检测采用透射比浊法进行测定。血乳酸水平用比色法检测;采用Logistic回归分析重症肺炎28d死亡的危险因素;采用ROC曲线分析SOFA评分联合血清IL-6、CRP、乳酸检测水平对重症肺炎28d预后的预测效能。结果 两组患者的性别、年龄、基础疾病个数和体重质量情况均无统计学差异(P>0.05);死亡组的SOFA评分分数以及血清IL-6、CRP、乳酸检测水平均高于生存组,且差异具有统计学意义(P<0.05);多因素Logistic回归结果显示,SOFA评分分数以及IL-6、CRP、乳酸检测水平都是重症肺炎患者28d死亡的危险因素(P<0.05);由ROC曲线分析可得,SOFA评分以及血清IL-6、CRP、乳酸检测水平预测重症肺炎28d预后的AUC分别为:0.816,0.719。0.782,0.799;灵敏度分别为:65.8%,57.9%,78.9%,63.2%;特异度分别为:88.3%,80.0%,81.7%,88.3%;四个指标联合预测的AUC为0.917,灵敏度为80.9%,特异度为90.3%。结论 SOFA评分分数以及IL-6、CRP、乳酸检测水平越高的重症肺炎患者,其28d死亡的风险越高;SOFA评分联合血清IL-6、CRP、乳酸检测水平对于重症肺炎28d预后具有较高的预测效能。Objective To explore the predictive fficacy of Sequential Organ Failure Asessment(SOFA)secore com-bined with serum interleukin-6(IL-6),C-reactive protein(CRP)and laectale on 28-day prognosis of severe pneumopia.Methods Ninety-eight patients with severe pneumonia in our hospital from 2020 to 2023 were selected,and classified intosurvival group (n =60) and death group (n =38) according to the 28-day mortality status. The clinical data of participantswere collected,and patients were assessed using SOFA. Milliliters of fasting venous blood (5 ml) and peripheral arterialblood (2 ml) were subjected to complete IL-6,CRP and lactate tests using transmission turbidimetry and colorimetry. ThenLogistic regression analysis was performed to screen the risk factors for 28-day mortality of severe pneumonia,and receiveroperating characteristic (ROC) curve was plotted to evaluate the predictive efficacy of SOFA score combined with serum IL-6,CRP and lactate on the 28-day prognosis of severe pneumonia. Results No statistical difference was reported betweentwo groups in gender,age, number of comorbid underlying diseases, body weight and body mass index (P >0. 05). SOFAscore,serum IL-6,CRP,and lactate levels in death group were higher than those in survival group, with statistical difference(all P<0. 05). ROC curve denoted showed that the area under the curve (AUC) of SOFA score, serum IL-6, CRP,andlactate for predicting the 28-day prognosis of severe pneumonia was 0.816,0.719,0.782 and 0. 799, with sensitivity of65. 8% ,57. 9% ,78.9% and 63. 2% ,and specificity of 88. 3% ,80. 0% ,81. 7% , and 88. 3% , respectively. The AUC, sensitivityand specificity of combined test of SOFA score,serum IL-6,CRP,and lactate for predicting the 28-day prognosis ofsevere pneumonia were 0.917,80. 9% and 90.3%. Conclusion Severe pneumonia patients with higher SOFA score,serumIL-6, CRP, and lactate suffer a higher risk of 28-day mortality rate, furthermore,the combined test of SOFA score, serumIL-6,CRP,and lactate is of great predictive value for 28-day

关 键 词：SOFA评分 IL-6 CRP 乳酸 重症肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]