APRI评分对升主动脉手术患者术后并发症及早期死亡的预测价值  

Predictive value of APRl score for postoperative complications and early death of patients undergoing ascending aorta surgery

作　　者：钱丽慧 朱才民 赵章生 戚央聪 吴婧蔚 马幼丽 QIAN Lihui;ZHU Caimin;ZHAO Zhangsheng;Ql Yangcong;WU Jingwei;MA Youli(Department of Blood Transfusion,the Affiliated Lihuili Hospital of Ningbo University,Ningbo,Zhejiang315040,China;Department of Cardiothoracic Surgery,the Affiliated Lihuili Hospital of Ningbo University)

机构地区：[1]宁波大学附属李惠利医院输血科,浙江宁波315040 [2]宁波大学附属李惠利医院心脏大血管外科,浙江宁波315040

出　　处：《临床血液学杂志》2025年第2期91-95,100,共6页Journal of Clinical Hematology

摘　　要：目的:探究术前APRI[谷草转氨酶(aspartate transaminase, AST)和血小板计数(platelet, PLT)比值]评分对升主动脉手术患者术后并发症及早期死亡的预测价值。方法:对284例升主动脉手术患者术前分别进行AST、PLT检测,计算APRI评分;根据患者术后30 d内的生存情况分为死亡组(31例)和存活组(253例),根据患者术后是否发生并发症分为并发症组(121例)和无并发症组(163例),比较各组间APRI评分及血清学相关检测结果差异;将患者分为高APRI组和低APRI组,比较术后并发症及早期死亡发生情况差异;采用ROC分析APRI评分对早期死亡及各种并发症发生的预测价值。结果:死亡组与存活组、并发症组与无并发症组比较,术前APRI评分、PLT、AST等方面,差异有统计学意义(P<0.05);高APRI组患者30 d内死亡率、各种并发症发生率均高于低APRI组(P<0.05)。APRI评分预测30 d内死亡发生受试者工作特征(ROC)曲线下面积(AUC)为0.730,灵敏度为51.6%,特异度为89.3%;预测并发症发生AUC为0.705,灵敏度为51.2%,特异度为84.1%;预测体外膜肺氧合治疗的AUC最大,为0.830;预测体外膜肺氧合治疗的灵敏度最高,为82.3%;预测急性肺损伤的特异度最高,为94.1%。当APRI评分>0.830,患者30 d内死亡风险增加;当APRI评分>0.475,患者术后并发症发生率增加。结论:术前APRI评分对升主动脉手术患者术后并发症及早期死亡发生有一定的预测价值。Objective:To explore the predictive value of preoperative APRI(aspartate aminotransferaseLAST to platelet[PLT] ratio index)score for postoperative complications and early death of patients undergoing ascending aorta surgery.Methods:For 284 patients undergoing ascending aorta surgery,aspartate aminotransferase(AST)and platelet count(PLT)before operation were tested,and APRI score was calculated.Patients were divided into a death group(n=31)and a survival group(n=253)according to their survival conditions within 30 days after surgery.Patients were divided into a complication group(n=121)and a non-complication group(n=163)according to whether postoperative complications occurred.APRI scores and serological detection results were compared.Patients were divided into high APRI group and low APRI group to compare the incidence of postoperative complications and early death.The predictive value of APRI score for various complications and early death was analyzed by ROC.Results:Preoperative APRI score,PLT and AST were significantly different between the death group and the survival group,and between the complication group and the non-complication group(P<0.05).The incidence of the 30-day mortality and various complications in the high APRI group was higher than those in the low APRI group(P<0.05).APRI score predicted the incidence of the 30-day mortality with 0.730 AUC,51.6%sensitivity and 89.3%specificity.APRI score predicted the incidence of complications with 0.705 AUC,51.2%sensitivity and 84.1%specificity.The AUC of extracorporeal membrane oxygenation was the largest(0.830).The predicted sensitivity of extracorporeal membrane oxygenation was the highest(82.3%).The specificity of predicting acute lung injury was the highest(94.1%).When the APRI score>0.830,the risk of death within 30 days increased.When the APRI score>0.475,the incidence of postoperative complications increased.Conclusion:Preoperative APRI score may have a certain predictive value for postoperative complications and early death of patients undergoing a

关 键 词：APRI评分 谷草转氨酶 血小板计数 升主动脉手术 并发症 

分 类 号：R446.11[医药卫生—诊断学]