乳酸/清蛋白比值与脓毒症患者MODS的发生率及病死率的相关性
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李殿发

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R631

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江苏省苏州市科教兴卫工程(KJXW2013028)


Correlation between lactate/albumin ratio level and incidence of multiple organ dysfunction syndrome as well as mortality in patients with sepsis
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    摘要:

    目的研究乳酸/清蛋白比值与严重脓毒症或感染性休克患者多器官功能障碍综合征(MODS)发生率及病死率的相关性。方法对2012年1月—2013年9月某院入住重症监护病房(ICU)第1天出现严重脓毒症或感染性休克的54例患者的基本资料进行分析。结果入住ICU第1天 有30例(55.56%)患者伴有MODS,第2天有26例(53.06%)患者伴有MODS;入住ICU第1 、2天乳酸/清蛋白比值在MODS组和非MODS组之间比较,差异均具有统计学意义(均P<0.05)。多因素logistic回归分析提示,乳酸/清蛋白比值、PaO2/FiO2、APACHE Ⅱ评分是严重脓毒症患者预测MODS发生的独立危险因素。乳酸/清蛋白比值在MODS组和非MODS组、死亡组和非死亡组之间比较,差异均具有统计学意义(均P<0.05);乳酸/清蛋白比值与APACHE Ⅱ评分、PaO2/FiO2比值呈现相关性,APACHE Ⅱ评分越高、PaO2/FiO2越低,乳酸/清蛋白比值越高。运用ROC曲线下面积分析入住ICU第1天的乳酸/清蛋白比值预测MODS发生率和病死率为0.85、0.84;乳酸/清蛋白比值>1.735预测MODS发生率的敏感性、特异性、阳性预测值及阴性预测值分别为80.00%、79.17%、82.67%、75.92%,预测病死率的敏感性、特异性、阳性预测值及阴性预测值分别为100.00%、51.02%、17.23%、100.00%。结论乳酸/清蛋白比值与严重脓毒症或感染性休克患者MODS发生率及病死率密切相关。

    Abstract:

    ObjectiveTo study the correlation between lactate/albumin ratio level and incidence of multiple organ dysfunction syndrome (MODS) as well as mortality in patients with severe sepsis or septic shock.MethodsIn January 2012September 2013, 54 patients who were admitted to the intensive care unit(ICU) of a hospital developed severe sepsis and septic shock on the first day of admission, clinical data of patients were analyzed. ResultsOn the first and second days of admission, 30(55.56%)and 26(53.06%)patients developed MODS;lactate/albumin ratio between MODS group and nonMODS group on the first and second days of admission were both significantly different (both P<0.05). Multivariate logistic regression analysis showed that lactate/albumin ratio, oxygenation index (PaO2/FiO2), as well as acute physiology and chronic health evaluation (APACHE Ⅱ) were independent risk factors for predicting MODS in patients with severe sepsis. Lactate/albumin ratios between MODS group and nonMODS group, death group and nondeath group were both significantly different (both P<0.05); lactate/albumin ratio was correlated with APACHE Ⅱand PaO2/FiO2, the higher the APACHE Ⅱ score and the lower the PaO2/FiO2, the higher of lactate/albumin ratio. The area under the receiver operating curve (ROC curve) analysis showed that incidence and mortality of MODS on the first day of admission predicted by lactate /albumin ratio were 0.85 and 0.84 respectively; sensitivity, specificity, positive predictive value, and negative predictive value of occurrence of MODS predicted by lactate /albumin ratio>1.735 were 80.00%, 79.17%, 82.67%, and 75.92% respectively, sensitivity, specificity, positive predictive value, and negative predictive value of mortality were 100.00%, 51.02%, 17.23%, and 100.00% respectively. ConclusionLactate/albumin ratio level is closely correlated with incidence and mortality of MODS in patients with severe sepsis or septic shock.

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王标,王泽宇,徐蓉,等.乳酸/清蛋白比值与脓毒症患者MODS的发生率及病死率的相关性[J]. 中国感染控制杂志,2017,16(5):417-422. DOI:10.3969/j. issn.1671-9638.2017.05.006.
WANG Biao, WANG Zeyu, XU Rong, et al. Correlation between lactate/albumin ratio level and incidence of multiple organ dysfunction syndrome as well as mortality in patients with sepsis[J]. Chin J Infect Control, 2017,16(5):417-422. DOI:10.3969/j. issn.1671-9638.2017.05.006.

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  • 收稿日期:2016-06-16
  • 最后修改日期:2016-09-12
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  • 在线发布日期: 2017-05-26
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