淋巴细胞-C 反应蛋白比值对重症监护病房脓毒症患者临床预后的预测价值：一项回顾性单中心研究

IF 3.9 3区生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Frontiers in Molecular Biosciences Pub Date : 2024-09-13 DOI:10.3389/fmolb.2024.1429372

Chao Song, Zhenkui Hu, Jinhui Zhang

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引用次数: 0

摘要

背景淋巴细胞与C反应蛋白比值（LCR）是一种新型的炎症生物标志物，与多种疾病有关。然而，LCR 在重症监护病房（ICU）脓毒症患者中的作用尚未得到彻底阐明。本研究旨在确定 LCR 在预测 ICU 败血症患者预后方面的意义。然后根据患者的 LCR 水平将其分为四等分。研究的主要终点是 30 天死亡率，次要终点是急性肾损伤（AKI）的发生率。通过卡普兰-梅耶法和对数秩检验进行生存分析，以评估生存率。采用 Cox 比例危险回归和逻辑回归模型来研究 LCR 与临床结果之间的关系。另外还进行了亚组分析，以评估其他混杂因素对 LCR 与患者预后之间关系的影响。30天死亡率为28.1%，而AKI发生率为45.6%。研究发现，LCR水平的逐渐降低与30天死亡率累积发生率的增加有关（对数秩P < 0.001）。多变量 Cox 比例危险度分析表明，LCR 是 30 天死亡率的独立预测因子[LCR 每增加 1 个单位：HR (95%CI)：0.370 (0.142-0.963)；P = 0.042]。此外，多变量逻辑回归分析显示 LCR 与 AKI 发生率之间存在显著关联[LCR 每增加 1 个单位：OR (95%CI)：0.541 (0.307-0.953)；P = 0.034]。此外，亚组分析表明，与 65 岁或以下的患者相比，65 岁以上的患者在根据 LCR 预测 30 天死亡率或 AKI 发生率方面具有更强的相关性（交互作用 <0.05 的 P）。这些研究结果表明，LCR 有可能成为识别脓毒症患者不良预后高风险的重要工具。

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The value of lymphocyte-to-C-reactive protein ratio for predicting clinical outcomes in patients with sepsis in intensive care unit: a retrospective single-center study

BackgroundThe lymphocyte-to-C-reactive protein ratio (LCR) was a novel biomarker of inflammation that had been implicated in various diseases. Nevertheless, the role of LCR in the context of sepsis patients admitted to the Intensive Care Unit (ICU) had not been thoroughly elucidated. This study aimed to determine the significance of the LCR in predicting the prognosis of sepsis patients within ICU.MethodsA sample of sepsis patients requiring ICU care was selected from the Affiliated Hospital of Jiangsu University. These patients were then segmented into four quartiles based on their LCR levels. The primary endpoint of the study was 30-day mortality and the secondary endpoint was the occurrence of Acute Kidney Injury (AKI). Survival analysis, via the Kaplan-Meier method and log-rank test, was conducted to assess survival rates. Cox proportional hazards regression and logistic regression models were employed to investigate the association between LCR and clinical outcomes. Additional subgroup analyses were conducted to evaluate the influence of other confounding factors on the relationship between LCR and patient outcomes.ResultsA total of 1,123 patients were enrolled in this study, with a median age of 75 (65–84) years, and 707 (63.0%) of them were male. The 30-day mortality rate was 28.1%, while the incidence of AKI was 45.6%. A progressive decrease in LCR levels was found to be associated with an increased cumulative incidence of 30-day mortality (log-rank P < 0.001). Multivariable Cox proportional hazards analyses demonstrated that LCR was an independent predictor of 30-day mortality [per 1-unit increase in LCR: HR (95%CI): 0.370 (0.142–0.963); P = 0.042]. Additionally, multivariable logistic regression analysis revealed a significant association between LCR and AKI occurrence [per 1-unit increase in LCR: OR (95%CI): 0.541 (0.307–0.953); P = 0.034]. Furthermore, subgroup analysis indicated a stronger correlation for patients aged over 65 years compared to those aged 65 or younger (p for interaction <0.05) in predicting 30-day mortality or AKI occurrence based on LCR.ConclusionA reduction in LCR was notably linked to 30-day mortality and the occurrence of AKI in sepsis patients. These findings suggested that LCR could potentially serve as a valuable tool in identifying sepsis patients at a heightened risk of adverse outcomes.

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来源期刊

Frontiers in Molecular Biosciences Biochemistry, Genetics and Molecular Biology-Biochemistry

CiteScore

7.20

自引率

4.00%

发文量

1361

审稿时长

14 weeks

期刊介绍： Much of contemporary investigation in the life sciences is devoted to the molecular-scale understanding of the relationships between genes and the environment — in particular, dynamic alterations in the levels, modifications, and interactions of cellular effectors, including proteins. Frontiers in Molecular Biosciences offers an international publication platform for basic as well as applied research; we encourage contributions spanning both established and emerging areas of biology. To this end, the journal draws from empirical disciplines such as structural biology, enzymology, biochemistry, and biophysics, capitalizing as well on the technological advancements that have enabled metabolomics and proteomics measurements in massively parallel throughput, and the development of robust and innovative computational biology strategies. We also recognize influences from medicine and technology, welcoming studies in molecular genetics, molecular diagnostics and therapeutics, and nanotechnology. Our ultimate objective is the comprehensive illustration of the molecular mechanisms regulating proteins, nucleic acids, carbohydrates, lipids, and small metabolites in organisms across all branches of life. In addition to interesting new findings, techniques, and applications, Frontiers in Molecular Biosciences will consider new testable hypotheses to inspire different perspectives and stimulate scientific dialogue. The integration of in silico, in vitro, and in vivo approaches will benefit endeavors across all domains of the life sciences.