摘要
目的探讨全身免疫炎症指数(SII)联合序贯器官衰竭评分(SOFA)及年龄对重症监护室(ICU)肺源性脓毒症患者预后的预测价值。方法选取2021年10月至2023年10月期间入住安徽医科大学第一附属医院ICU的肺源性脓毒症患者的临床和实验室参数,包括一般资料、合并症、临床评分、实验室指标及28天预后,并计算SII,以28天预后为观察指标,采用多因素Cox回归分析肺源性脓毒症患者预后不佳的影响因素。受试者工作特征曲线(ROC)分析不同因素对患者28天死亡率的预测效能。结果共纳入99例肺源性脓毒症患者,根据28天转归分为存活组60例与死亡组39例。死亡组患者年龄、APACHEⅡ评分、血肌酐、PCT、CRP、SOFA评分和SII水平显著升高(P<0.05)。多因素分析显示SII、SOFA评分和年龄是患者28天死亡率的危险因素(P<0.05)。SII和SOFA评分预测肺源性脓毒症预后的AUC分别为0.703和0.671,而SII+SOFA评分+年龄三者联合预测的AUC为0.804,SII+SOFA评分+年龄联合的预测能力强于SII(Z=2.718,P=0.008)和SOFA(Z=3.412,P<0.001)。结论SII、SOFA评分和年龄是肺源性脓毒症患者28天死亡率的影响因素,且三者联合预测价值更高。
Objective To explore the predictive value of systemic immune inflammatory index(SII)combined with sequential organ failure assessment(SOFA)and age for the prognosis of patients with pulmonary sepsis in intensive care unit(ICU).Methods Clinical and laboratory parameters,including general information,comorbidities,clinical scores,laboratory indicators,and 28 day prognosis,were selected from patients with pulmonary sepsis admitted to the ICU of the First Affiliated Hospital of Anhui Medical University from October 2021 to October 2023.The SII was calculated,and the 28 day prognosis was used as the observation indicator.Multivariate Cox regression analysis was conducted to identify the factors affecting poor prognosis in patients with pulmonary sepsis.Receiver Operating Characteristic(ROC)analysis of the predictive power of different factors on 28 day mortality rate in patients.Results A total of 99 patients with pulmonary sepsis were included and divided into a survival group of 60 cases and a death group of 39 cases based on 28 day outcomes.Their age,APACHEⅡscore,serum creatinine,PCT,CRP,SOFA,and SII level of the death group patients significantly increased(P<0.05).Multivariate analysis showed that SII,SOFA,and age were risk factors for 28 day mortality in patients(P<0.05).The AUC of SII and SOFA scores for predicting the prognosis of pulmonary sepsis were 0.703 and 0.671,respectively,while the AUC of SII+SOFA+age combined prediction was 0.804,and the predictive ability of SII+SOFA+age combination was stronger than that of SII(Z=2.718,P=0.008)and SOFA(Z=3.412,P<0.001).Conclusion SII,SOFA,and age are the influencing factors of 28 day mortality in patients with pulmonary sepsis,and the combined predictive value of the three is higher.
作者
王小倩
王洁玲
常静静
王楠
WANG Xiaoqian;WANG Jieling;CHANG Jingjing;WANG Nan(Department of Intensive Care Medicine,the First Affiliated Hospital of Anhui Medical University(Anhui Public Health Clinical Center),Hefei,Anhui 230000,China)
出处
《临床肺科杂志》
2025年第8期1187-1190,1196,共5页
Journal of Clinical Pulmonary Medicine
基金
安徽省转化医学研究院科研基金项目(2022zhyx-C66)
安徽省高校自然科学研究项目(2023AH050677)。
