乳酸/白蛋白比值对败血症患者死亡和多器官功能障碍综合征的预测价值

Shuwei Huang
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摘要

简介多器官功能障碍综合征(MODS)是败血症后的常见病,会增加死亡率。乳酸(Lac)可评估患者的预后。白蛋白(Alb)与败血症患者的炎症反应密切相关。本研究评估了 Lac/Alb 对败血症患者预后的预测价值。材料和方法:回顾性收集了 160 名败血症患者的数据。分别在入院时、24 小时和 48 小时后测量 Lac 和 Alb 水平。以 0.45 作为 Lac/Alb 的临界值,将患者分为高水平组(HL)和低水平组(LL)。对 MODS 率和死亡率进行了分析。利用接收者操作特征曲线(ROC)评估 48 小时 Lac/Alb 对患者预后的预测价值。评估了 Lac/Alb 与 APACHE II 和 SOFA 评分之间的相关性。结果:12 个月的随访显示,52 例死亡(32.5%),49 例(30.6%)在第 7 天出现 MODS。MODS 组的 Lac 和 Lac/Alb 升高,Alb 下降(P<0.05),与 N-MODS 组相比,生存组和死亡组的结果相似(P<0.05)。Lac/Alb 预测 MODS 的灵敏度、特异性和 ROC 曲线下面积(AUC)分别为 81.63%、85.59% 和 0.89,而预测死亡的灵敏度、特异性和 ROC 曲线下面积(AUC)分别为 94.23%、88.89% 和 0.91。Lac/Alb 与 APACHE II 和 SOFA 评分呈正相关(r=0.718 和 0.808)。结论Lac/Alb 与脓毒症患者的 MODS 和死亡率有关,可用于预测不良预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictive Value of Lactate/Albumin Ratio for Death and Multiple Organ Dysfunction Syndrome in Patients with Sepsis
Introduction: Multiple organ dysfunction syndrome (MODS) is common after sepsis and increases mortality. Lactate (Lac) can assess the prognosis of patients. Albumin (Alb) is closely associated with inflammatory response in sepsis patients. This work evaluated the predictive value of Lac/Alb for prognosis of sepsis patients. Materials and Methods: data of 160 sepsis patients were retrospectively collected. Lac and Alb levels were measured upon admission, at 24 hours and 48 hours later. Using 0.45 as the cutoff value for Lac/Alb, patients were rolled into high-level (HL) and low-level (LL) groups. MODS rates and mortality rates were analyzed. Receiver operating characteristic (ROC) curves were utilized to evaluate the predictive value of 48-hour Lac/Alb for patient prognosis. Correlation between Lac/Alb and APACHE II and SOFA scores was assessed. Results: the 12-month follow-up revealed 52 deaths (32.5%), and MODS occurred in 49 cases (30.6%) on the 7th day. The MODS group possessed elevated Lac and Lac/Alb and decreased Alb to the N-MODS group (P<0.05), and similar results were observed by comparison the survival and death group (P<0.05). The sensitivity, specificity, and area under the ROC curve (AUC) of Lac/Alb in predicting MODS were 81.63%, 85.59%, and 0.89, respectively, while those in predicting death were 94.23%, 88.89%, and 0.91, respectively. Lac/Alb was positively correlated with APACHE II and SOFA scores (r=0.718 and 0.808, respectively). Conclusion: Lac/Alb was linked to MODS and mortality in sepsis patients and can be based to predict adverse outcomes.
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