摘要
目的:探讨脓毒症患者凝血功能、乳酸及炎性因子相关性及对预后的评价。方法:选取2023年1月-2024年6月本院重症医学科收治的85例脓毒症患者,根据入院28天内是否死亡分为存活组(43例)和死亡组(42例),对比两组患者入院时凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)],乳酸(LAC)、炎性因子包括白细胞(WBC)、降钙素原(PCT)、C反应蛋白(CRP)。分析凝血功能及LAC、WBC、CRP、PCT的相关性。通过受试者工作特征(ROC)曲线分析上述指标单独或联合对脓毒症患者28天是否死亡的预测价值。结果:死亡组PT、APTT、LAC、CRP、PCT、WBC指标均明显高于存活组(P<0.05);Pearson相关性分析显示,脓毒症患者PT、APTT与LAC、CRP、PCT、WBC水平均呈正相关(P<0.05)。ROC曲线分析提示WBC、PCT、CRP、LAC、APTT预判患者28天死亡的ROC曲线下面积(AUC)分别为0.65、0.88、0.85、0.74、0.65;APTT联合PCT后AUC为0.90,敏感度和特异度为92.90%、74.40%;APTT联合CRP后AUC为0.86,敏感度和特异度为90.50%、76.70%。结论:PT、APTT、LAC、CRP、PCT、WBC多指标的检测联合应用于脓毒症的诊疗,有助于预测脓毒症患者短期(28天)预后状况。
Objective:To investigate the correlation between coagulation function,lactic acid and inflammatory factors in patients with sepsis and evaluate their effects on prognosis.Method:A total of 85 sepsis patients from January 2023 to June 2024 were selected and divided into survival group(43 cases)and death group(42 cases)according to whether they died 28d after admission.The indexes of blood coagulation function such as prothrombin time(PT)and activated partial thrombin time(APTT),lactic acid(LAC),inflammatory factors were compared.The correlation of coagulation function,LAC,WBC,CRP and PCT was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the above indicators alone or in combination for the death of patients with sepsis at 28 days.Results:The indexes of PT,APTT,LAC,CRP,PCT and WBC in death group were significantly higher than those in survival group(P<0.05).Pearson correlation analysis revealed that PT and APTT in sepsis patients showed positive correlations wiht LAC,CRP,PCT and WBC(P<0.05).ROC curve analysis showed that the area under ROC curve(AUC)of WBC,PCT,CRP,LAC and APTT for predicting death at 28 days were 0.65,0.88,0.85,0.74 and 0.65,respectively.The AUC of APTT combined with PCT was 0.90,and the sensitivity and specificity were 92.90% and 74.40%,respectively.The AUC of APTT combined with CRP was 0.86,the sensitivity and specificity were 90.50% and 76.70%,respectively.Conclusion:The combined detection of multiple indicators such as PT,APTT,LAC,CRP,PCT and WBC in the diagnosis and treatment of sepsis is beneficial for predicting the short-term(28-day)prognosis of sepsis patients.
作者
揭凤英
王倩
徐玲文
董芳
JIE Fengying;WANG Qian;XU Lingwen;DONG Fang(Department of Critical Care Medicine,Wuhan Third Hospital,Wuhan 430061,China)
出处
《微循环学杂志》
2025年第3期40-44,50,共6页
Chinese Journal of Microcirculation
基金
武汉市卫健委西医青年项目(WX20C27)。
关键词
脓毒血症
凝血指标
乳酸
炎症指标
预后
Sepsis
Coagulation index
Lactic acid
Inflammatory indicators
Prognosis
