摘要
目的:探讨乳酸(LAC)、降钙素原(PCT)、凝血酶原时间(PT)及D-二聚体(D-D)对老年脓毒症患者预后的评估效能,为临床病情评估提供依据。方法:选取2023年1月—2024年1月于武汉大学人民医院接受治疗的127例脓毒症患者,根据28天内是否死亡分为存活组(90例)和死亡组(37例)。采集两组患者入院3日内空腹静脉血,检测LAC、PCT、PT、D-D等相关指标,采用统计学方法分析两组指标差异、LAC与各指标的相关性及各指标对患者28天死亡率的预测价值。结果:死亡组LAC、PCT、PT、活化部分凝血活酶时间(APTT)、D-D、纤维蛋白原降解产物(FDP)水平及序贯器官衰竭评估(SOFA)评分、APACHEⅡ评分高于存活组,GLU、PLT、FIB、AT-Ⅲ水平低于存活组(P<0.05或P<0.01);LAC与PCT、PT、APTT、D-D、FDP、SOFA评分、APACHEⅡ评分呈正相关,与PLT、FIB、AT-Ⅲ呈负相关(P<0.05或P<0.01);Logistic回归分析显示LAC、PCT、PT、D-D是脓毒症患者28天预后不良的独立影响因素(P<0.05);受试者工作特征(ROC)曲线显示四者联合对脓毒症患者28天存活情况的预测价值更高(AUC=0.939)。结论:LAC、PCT、PT及D-D与脓毒症患者预后密切相关,四者联合检测可提高对脓毒症患者28天存活情况的预测价值。
Objective:To explore the evaluation efficacy of lactic acid(LAC),procalcitonin(PCT),prothrombin time(PT)and D-dimer(D-D)in the prognosis of elderly patients with sepsis,and to provide a basis for clinical condition assessment.Method:A total of 127 sepsis patients from January 2023 to January 2024 were selected and divided into the survival group(90 cases)and the death group(37 cases)according to whether they died within 28 days.Fasting venous blood was collected from both groups within 3 days of admission to detect relevant indicators such as LAC,PCT,PT and D-D.Statistical methods were used to analyze the differences of indicators between the two groups,the correlation between LAC and each indicator,and the predictive value of each indicator for the 28-day mortality of patients.Results:The levels of LAC,PCT,PT,APTT,D-D,FDP as well as SOFA and APACHEⅡ scores in the death group were higher than those in the survival group,while the levels of GLU,PLT,FIB and AT-Ⅲ were lower than those in the survival group(P<0.05 or P<0.01).LAC was positively correlated with PCT,PT,APTT,D-D,FDP,SOFA score and APACHEⅡ score,and negatively correlated with PLT,FIB and AT-Ⅲ(P<0.05 or P<0.01).Logistic regression analysis showed that LAC,PCT,PT and D-D were independent risk factors for poor prognosis within 28 days in sepsis patients(P<0.05).ROC curve showed that the combined detection of the four had a higher predictive value for the 28-day survival of sepsis patients(AUC=0.939).Conclusion:LAC,PCT,PT and D-D are closely related to the prognosis of sepsis patients,and the combined detection of the four can improve the predictive value for the 28-day survival of sepsis patients.
作者
匡贤栋
周俊杰
汤冬玲
张平安
KUANG Xiandong;ZHOU Junjie;TANG Dongling;ZHANG Pingan(Department of Clinical Laboratory,Wuhan University People's Hospital(Institute of Translational Medicine),Wuhan 430060,China)
出处
《微循环学杂志》
2025年第3期51-55,共5页
Chinese Journal of Microcirculation
基金
国家自然科学基金(81773444)。
