摘要
目的探讨强离子隙(SIG)对脓毒症患者预后的评估价值。方法收集2017年1月-2020年4月于安庆市某三甲医院重症医学科(ICU)诊治的脓毒症患者共53例作为研究对象。收集患者入ICU 24 h内血气、血生化等指标水平,应用Stewart-Figge方法学的方程式计算SIG。记录患者一般临床资料包括年龄、性别、动脉血乳酸水平(Lac)、序贯器官衰竭(SOFA)评分、预后情况等指标。根据患者预后情况分为存活组和死亡组,比较两组患者在上述指标的差异;绘制受试者工作特征曲线(ROC)分析上述指标单独预测、联合预测脓毒症患者预后的临床价值。结果53例患者中存活组32例和死亡组21例,总体病死率为39.6%;死亡组的SIG、Lac、SOFA分别为(17.1±7.4)mmol/L、(7.1±3.5)μg/L、12.0(10.5,12.5)分,均显著高于存活组,差异均有统计学意义(P<0.05)。ROC曲线分析显示,SIG、Lac、SOFA评分、SIG+Lac+SOFA评分的ROC曲线下面积(AUC)分别为0.798、0.757、0.863和0.934,各指标对脓毒症患者预后均有一定的预测价值,以三者联合预测价值最大。结论SIG作为一项新的指标,可对脓毒症患者预后有一定的预测价值;SIG、Lac、SOFA评分联合检测可提高预测脓毒症患者预后的准确性。
Objective To investigate the evaluation value of strong ion gap(SIG)in prognosis of sepsis patients.Methods A total of 54 sepsis patients in the intensive care unit(ICU)of a grade 3 and first-class hospital from January 2017 to April 2020 were studied.On the basis of determination of blood gas and biochemistry,Stewart-Figge model wasused to calculate SIG,and the general information including age,sex,arterial lactic acid(Lac),sequential organ failureassessment(SOFA)score and the clinical outcome were recorded.The patients were divided into survival group and deathgroup according to the prognosis,and the differences in the above indicators between the groups were compared.The receiveoperating characteristic curves(ROC)were establish to analysis the value of the single or multiple indexes for predicting theprognosis of sepsis patients.Results The fatality rate of the 53 sepsis patients was 39.6%.The level of SIG,Lac andSOFA score[(17.1±7.4)mmol/L,(7.1±3.5)μg/L,12.0(10.5,12.5)score]in death group were all significantly higher thansurvival group(P<0.05).The area under the ROC curve(AUC)of SIG,Lac,SOFA score and SIG+Lac+SOFA score were0.798,0.757,0.863 and 0.934,respectively,indicating that the combined predictive value of them was higher than thethree single indicators.Conclusion SIG,as a new indicator,could be used to assess the prognosis of sepsis and thecombination of the SIG,Lac and SOFA score had higher evaluation value.
作者
查君敬
方长太
白兆青
黄利娟
ZHA Jun-jing;FANG Chang-tai;BAI Zhao-qing;HUANG Li-juan(Department of Intensive Care Unit,Anqing Municipal Hospital,Anqing,Anhui 246003,China)
出处
《热带医学杂志》
CAS
2021年第1期91-93,F0002,共4页
Journal of Tropical Medicine
基金
安徽省2017年公益性技术应用研究联动计划项目(1704f0804036)。
关键词
强离子隙
脓毒症
预后
Strong ion gap
Sepsis
Prognosis
