脓毒症合并急性肾损伤患者PCT、CRP、SAA、CRP/ALB、NLR、NLPR水平应用价值分析  

Analysis of application value of PCT,CRP,SAA,CRP/ALB,NLR,NLPR levels in patients with sepsis complicated and acute renal injury

作　　者：查成喜[1] 漆亚亚 李国铎[1] 李建省[1] ZHA Cheng-xi;QI Ya-ya;LI Guo-duo;LI Jian-sheng(Department of Clinical Laboratory,Gansu Provincial Hospital of TCM,Lanzhou 730000,China;Department of Precision Medicine Experimental Center,the First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]甘肃省中医院检验科,兰州730000 [2]兰州大学第一医院精准医学实验中心,兰州730000

出　　处：《医药论坛杂志》2024年第23期2484-2488,共5页Journal of Medical Forum

基　　金：国家自然科学地区基金(82360884)。

摘　　要：目的研究降钙素原(procalcitonin,PCT)、C反应蛋白(C reaction protein,CRP)、血清淀粉样蛋白A(serum amyloid A,SAA)、C反应蛋白与白蛋白(albumin,ALB)比值(CRP/ALB)、中性粒细胞绝对值与淋巴细胞绝对值比值(neutnphil lymphocyte ratio,NLR)、中性粒细胞绝对值与淋巴细胞绝对值和血小板比值绝对值(neutnphil to lymphocyte and platelet ratio,NLPR)在脓毒症并发急性肾损伤(acute renal injury,AKI)患者中的应用价值。方法收集2020年9月—2023年8月就诊于甘肃省中医院确诊为脓毒症合并急性肾损伤患者125例,依据肾小球滤过率进行AKI分期,其中Ⅰ期39例、Ⅱ期48例、Ⅲ期38例;同时选取未并发AKI患者100例,比较两组患者PCT、CRP、SAA、CRP/ALB、NLR、NLPR水平,采用受试者工作特征(receiver operating characteristic,ROC)曲线评价上述指标对脓毒症患者并发AKI的预测价值。结果两组患者性别、年龄、体重指数(BMI)、APACHEⅡ评分以及基础疾病等一般资料比较,差异均不具有统计学差异(P>0.05);AKI组患者的PCT、CRP、SAA、Cys-C、NLR、NLPR、CRP/ALB明显高于非AKI组,差异具有统计学意义(P<0.05)。AKI组患者的ALB明显低于非AKI组,差异具有统计学意义(P<0.05)。不同分期的AKI组患者之间比较,Ⅰ期患者PCT、CRP、SAA、Cys-C、NLR、NLPR、CRP/ALB明显低于Ⅱ期患者组,差异具有统计学意义(P<0.05)。Ⅱ期患者PCT、CRP、SAA、Cys-C、NLR、NLPR、CRP/ALB明显低于Ⅲ期患者组,差异具有统计学意义(P<0.05)。AKI组ALB比较表明,Ⅰ期明显高于Ⅱ期,差异具有统计学意义(P<0.05);Ⅱ期ALB明显高于Ⅲ期,差异具有统计学意义(P<0.05)。二分类logistic回归分析,结果显示PCT、SAA、NLR、NLPR、CRP/ALB均为脓毒症合并AKI的独立预测指标。ROC曲线结果显示,PCT的截断值为5.605,曲线下面积为0.972;CRP的截断值为71.5,曲线下面积为0.840;SAA的截断值为150.6,曲线下面积为0.978;ALB的截断值为33.45,曲线下面积为0.871;CYObjective To explore the diagnostic value of procalcitonin(PCT),C reaction protein(CRP),serum amyloid A(SAA)CRP/albumin(ALB),NLR,NLPR in sepsis patients with acute renal injury(AKI).Methods Totally 125 patients with sepsis combined with acute kidney injury attended the Gansu Provincial Hospital of TCM between September 2020 and August 2023 were collected,and AKI staging was performed based on glomerular filtration rate.Among them,39 patients were in stage I,48 patients were in stage II,and 38 patients were in stage III;at the same time,100 patients with sepsis without acute kidney injury were selected to compare the levels of PCT,CRP,SAA,CRP/ALB,NLR,and NLPR between two groups of patients.The predictive value of PCT,CRP,SAA,CRP/ALB,NLR,and NLPR for sepsis patients with AKI was evaluated using the receiver operating characteristic(ROC)curve.Results There was no statistically significant difference in general data such as gender,age,BMI,APACHE II score,and underlying diseases between the AKI group and the non AKI group(P>0.05).There were statistically significant between PCT,CRP,SAA,Cys-C,NLR,NLPR,CRP/ALB of AKI patients and those of the non AKI group(P<0.05).The ALB of AKI group patients was significantly lower than that of non AKI group and the difference was statistically significant(P<0.05).Compared with AKI group patients at different stages,PCT,CRP,SAA,Cys-C,NLR,NLPR,CRP/ALB of stage II patients were significantly higher than that of stage I patients,and the difference was statistically significant(P<0.05).Compared to that of the stage III patients,the difference was statistically significant in the PCT,CRP,SAA,Cys-C,NLR,NLPR,CRP/ALB of stage II patients(P<0.05).However,the ALB of stage I patients was significantly higher than that of stage II patients,and that of stage II patients was significantly higher than that of stage III patients,and the difference were statistically significant(P<0.05).The logistic regression analysis showed that PCT,SAA,NLR,NLPR,CRP/ALB were all independent risk factors for sepsis c

关 键 词：脓毒症 降钙素原 C反应蛋白/白蛋白 中性粒细胞/淋巴细胞 中性粒细胞计数/淋巴细胞和血小板计数 急性肾损伤 

分 类 号：R692[医药卫生—泌尿科学]