摘要
目的 探讨血清降钙素原(PCT)/白蛋白(ALB)与脓毒症相关性脑病(SAE)患者预后的关系。方法 本研究为一项前瞻性研究,纳入2017年1月至2022年12月河南科技大学第一附属医院104例SAE患者为研究对象。于患者入院第1天检测血清PCT、ALB水平,计算血清PCT/ALB值。对患者开展系统治疗,随访30 d,随访终点为患者病死或随访结束,统计患者预后结局。设计患者一般资料调查表,将可能的因素纳入,经Cox回归分析检验PCT/ALB值与SAE患者预后的关系。结果 104例SAE患者共完成随访102例。随访期间,102例患者中病死33例,占32.35%(33/102)。病死组治疗前血清PCT、PCT/ALB值高于存活组,血清ALB水平低于存活组(P<0.05)。病死组治疗前序贯器官衰竭(SOFA)评分高于存活组(P<0.05)。经Cox回归分析,结果显示,血清PCT水平高、PCT/ALB值高、ALB水平低、SOFA评分高与SAE患者不良预后结局有关(P<0.05)。绘制受试者工作特征(ROC)曲线,结果显示,血清PCT、ALB、PCT/ALB值预测SAE患者不良预后结局的曲线下面积(AUC)均≥0.7,有一定的预测价值,其中PCT/ALB值预测价值最高。结论 血清PCT/ALB值与SAE患者预后有关,血清PCT/ALB值高会增加患者病死率,早期检测血清PCT/ALB值可用于预测SAE患者不良预后发生风险。
Objective To investigate the relationship between the serum procalcitonin(PCT)/albumin(ALB)and the prognosis of patients with sepsis-associated encephalopathy(SAE).Methods This study was a prospective study involving 104 SAE patients in the First Affiliated Hospital of Henan University of Science and Technology from January 2017 to December 2022.On the first day of admission,serum PCT and ALB levels were measured and serum PCT/ALB was calculated.The patients were treated systematically and followed up for 30 days.The end point of follow-up was the patients’death or follow-up deadline,and the prognosis of the patients was counted.A general data questionnaire was designed to include possible factors.Cox regression analysis was conducted to examine the relationship between PCT/ALB and the prognosis of SAE patients.Results A total of 102 of 104 SAE patients completed follow-up work.During the follow-up period,33 of the 102 patients died,accounting for 32.35%(33/102).Before treatment,the serum PCT and PCT/ALB in the death group were higher than those in the survival group,while the serum ALB level was lower than that in the survival group(P<0.05).The score of sequential organ failure(SOFA)in the death group before treatment was higher than that in the survival group(P<0.05).Cox regression analysis showed that high levels of serum PCT,PCT/ALB,low serum ALB and high SOFA score were associated with poor prognosis in SAE patients(P<0.05).The receiver operating characteristic(ROC)curve was drawn,and the results showed that the area under the curve(AUC)of serum PCT,ALB and PCT/ALB in predicting adverse outcome in SAE patients was≥0.7,all of which had certain predictive value,with PCT/ALB having the highest predictive value.Conclusion The serum PCT/ALB is related to the prognosis of SAE patients.High serum PCT/ALB can increase the mortality rate of patients.Early detection of serum PCT/ALB can be used to predict the risk of adverse prognosis in SAE patients.
作者
邵艳敏
徐锦锦
沈瑞乐
SHAO Yanmin;XU Jinjin;SHEN Ruile(Department of Neurology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)
出处
《河南医学研究》
CAS
2023年第20期3697-3700,共4页
Henan Medical Research
关键词
脓毒症相关性脑病
降钙素原
白蛋白
预后
预测价值
sepsis-associated encephalopathy
procalcitonin
albumin
prognosis
predictive value
