摘要
目的:联合肾动脉阻力指数、β2微球蛋白、降钙素原水平构建脓毒症合并急性肾损伤患者预后模型的验证评价。方法:选取2019年10月—2020年12月期间在我院内科及ICU进行治疗的107例脓毒症合并急性肾损伤患者作为研究对象。根据患者预后情况分为存活组(79例)和死亡组(28例)。比较两组患者肾动脉阻力指数(RRI)、β2微球蛋白(β2-MG)和降钙素原(PCT)各指标表达水平,同时采用Cox比例风险回归分析RRI、β2-MG和PCT各指标表达水平对脓毒症合并急性肾损伤患者预后情况的诊断价值,最后通过ROC曲线分析患者RI、β2-MG和PCT各指标表达水平对脓毒症合并急性肾损伤患者预后的预测能力。结果:死亡组患者RRI、β2-MG和PCT各指标表达水平明显高于存活组,两组之间差异有统计学意义(P<0.05);采用Cox比例风险回归分析结果显示,RRI、β2-MG和PCT各指标表达水平升高均为脓毒症合并急性肾损伤患者预后的独立危险因素;最后通过受试者工作特征曲线(ROC)分析结果显示,RRI、β2-MG和PCT单独预测脓毒症合并急性肾损伤患者预后的曲线下面积(AUC)分别为0.703、0.745、0.747,而三者联合检测预测脓毒症合并急性肾损伤患者预后的曲线下面积(AUC)为0.897,联合检测评估脓毒症合并急性肾损伤患者预后的曲线下面积(AUC)明显更优于单一指标的预测概率。RRI、血清β2-MG和PCT诊断脓毒症合并肾损伤患者预后的最佳截断值分别为1.37、4.57 mg/L和4.46 ng/mL。结论:RRI、β2-MG和PCT各指标表达水平与脓毒症合并急性肾损伤患者预后情况关系密切,联合检测RRI、β2-MG和PCT 3项指标可提高对脓毒症合并急性肾损伤患者的预后预测效能,同时可有效评估脓毒症合并急性肾损伤患者的预后。
Objective:Combined with renal artery resistance index(RRI),β2 microglobulin(β2-MG),and procalcitonin(PCT)levels,the validation and evaluation of the prognosis model of patients with sepsis and acute kidney injury injury was constructed.Methods:One hundred and seven patients with sepsis and acute kidney injury t who were treated in the Internal Medicine Department and ICU of our hospital from October 2019 to December 2020 were selected as the research objects.According to the prognosis of patients with sepsis and acute kidney injury,they were divided into survival group(n=79)cases and death group(n=28)cases.The RRI,β2-MG and PCT expression levels were compared between the two groups of patients.At the same time,multivariate Cox proportional hazards regression was used to analyze RRI,β2-MG and the diagnostic value of the expression levels of PCT indicators on the prognosis of patients with sepsis and acute kidney injury.Finally,the ROC curve was used to analyze the prognosistic value of expression levels of RRI,β2-MG and PCT in patients with sepsis andacute kidney injury.Results:The expression levels of RRI,β2-MG and PCT in the death group were significantly higher than those in the survival group.The difference was statistically significant(P<0.05).The results of multivariate Cox proportional hazards regression regression analysis showed that patients with sepsis and acute kidney injury Increased expression levels of RRI,β2-MG and PCT are all independent risk factors for the prognosis of patients with sepsis andacute kidney injury Finally,the results of receiver operating characteristic curve(ROC)analysis showed that sepsis.The area under the curve(AUC)of RRI,β2-MG and PCT in patients with acute kidney injury and sepsis individually predicting the prognosis of patients with sepsis and acute kidney injury are 0.703,0.745,and 0.747,respectively,and the combined detection of the three predicts patients with sepsis and acute kidney injury The prognostic area under the curve(AUC)is 0.897.The area under the curve(AUC)of combined testing to assess the prognosis of patients with sepsis and acute kidney injury is significantly better than the predictive probability of a single index.The optimal cut-off values of RRI,serumβ2-MG and PCT to diagnose the prognosis of patients with sepsis complicated with renal injury were 1.37,4.57 mg/L and 4.46 ng/mL,respectively.Conclusion:The expression levels of RRI,β2-MG and PCT in patients with sepsis andacute kidney injury are closely related to the prognosis of patients with sepsis and acute kidney injury.The three indicators of RRI,β2-MG and PCT in patients with sepsis and acute kidney injury are jointly detected.It can improve the performance of predicting the prognosis of patients with sepsis and acute kidney injury and can effectively assess the prognosis of patients with sepsis and acute kidney injury.
作者
李佳
袁野
罗娟娟
张辉
LI Jia;YUAN Ye;LUO Juanjuan;ZHANG Hui(Department of Critical Care Medicine,Guangdong Provincial People's Hospital Zhuhai Hospital,Zhuhai Golden Bay Center Hospital,Zhuhai,Guangdong,519090,China;Department of Internal Medicine,Guangdong Provincial People's Hospital Zhuhai Hospital,Zhuhai Golden Bay Center Hospital,Hospital,Zhuhai,Guangdong,519090,China)
出处
《临床急诊杂志》
CAS
2022年第10期727-732,共6页
Journal of Clinical Emergency
