摘要
目的:探究急性下肢缺血(acute limb ischemia,ALI)患者急性生理学与慢性健康状况评分Ⅱ(acute physiology and chronic health e-valuation Ⅱ,APACHE Ⅱ)评分及血清cTnI、肌红蛋白(myoglobin,Mb)、CK-MB与预后的关系。方法:回顾性分析2018年1月至2022年1月张家口市第一医院收治的173例确诊为ALI患者,根据患者预后情况(28d转归)将患者分为存活组与死亡组,记录两组患者一般资料,比较两组APACHE II评分及cTnI、Mb、CK-MB水平,采用多因素COX回归分析研究ALI患者上述指标与预后的关系,采用Pearson相关性分析探究APACHE Ⅱ评分、血清cTnI、Mb、CK-MB之间的关系。绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析4种指标对于ALI患者预后的预测效能。结果:存活组APACHE Ⅱ评分及cTnI、Mb、CK-MB水平均低于死亡组(P<0.05);两组病变部位比较差异有统计学意义(P<0.05);两组慢性疾病、发病时间等其余临床资料比较差异无统计学意义(P>0.05);多因素COX回归分析中,结果显示APACHE II评分、Mb为ALI患者预后的影响因素(P<0.05);Pearson相关性分析结果显示APACHE II评分、血清cTnI、Mb、CK-MB水平均呈正相关(P<0.05);APACHE II评分及血清cTnI、Mb、CK-MB对ALI患者预后进行预测时,曲线下面积(area under the curve,AUC)值分别为0.924、0.852、0.922、0.895,4种指标的AUC比较差异无统计学意义(P>0.05)。结论:不同预后情况的ALI患者APACHE II评分及血清cTnI、Mb、CK-MB差异显著,APACHE II评分、Mb为ALI患者预后的影响因素,APACHE II评分、血清cTnI、Mb、CK-MB水平存在显著相关性。4种指标均可对ALI患者预后进行预测。
Objective:o investigate the relationship of the acute physiology and chronic health evaluation(APACHE)Ⅱ score,serum cTnI,myoglobin(Mb),CK-MB and the prognosis in patients with acute lower limb ischemia(ALI).Methods:A total of 173 patients with ALI admitted to the Zhangjiakou First Hospital from January 2018 to January 2022 were selected as the research subjects.According to the prognosis(28-day outcome),the patients were divided into survival group and death group.General information of the two groups of patients was recorded.APACHE Ⅱ scores and the levels of cTnI,Mb and CK-MB were compared between the two groups.Multivariate COX regression analysis was used to study the relationship between above indicators and the prognosis in patients with ALI.Pearson’s correlation analysis was used to explore the relationship of APACHE Ⅱ score,serum cTnI,Mb,and CK-MB.The receiver operating characteristic(ROC)curves were used to analyze the predictive efficacy of four indicators for the prognosis of patients with ALI.Results:APACHE Ⅱ score and the levels of cTnI,Mb and CK-MB in the survival group were lower than those in the death group(P<0.05).There was a statistically significant difference in lesion location between the two groups(P<0.05),but there was no statistically significant difference in the other clinical data such as chronic diseases and onset time between the two groups(P>0.05).Multivariate COX regression analysis results showed that APACHE Ⅱ score and Mb were prognostic factors in patients with ALI(P<0.05).Pearson’s correlation analysis showed that APACHE Ⅱ score was positively correlated with serum cTnI,Mb,and CK-MB levels(P<0.05).For predicting the prognosis of patients with ALI,the areas under the curve(AUCs)of APACHE Ⅱ score,serum cTnI,Mb,and CK-MB were 0.924,0.852,0.922,and 0.895,showing no significant difference(P>0.05).Conclusions:APACHE Ⅱ scores and serum cTnI,Mb and CK-MB levels of ALI patients with different prognoses are significantly different.APACHE Ⅱ scores and Mb are prognostic factors in patients with ALI.There’s a significant correlation of APACHE Ⅱ score,serum cTnI,Mb,and CK-MB levels.All of the four indicators can be used to predict the prognosis of patients with ALI.
作者
刘明阳
杨志勇
刘琳
LIU Mingyang;YANG Zhiyong;LIU Lin(Department of Vascular Surgery,Zhangjiakou First Hospital,Zhangjiakou 075000,China)
出处
《心肺血管病杂志》
2025年第8期853-858,864,共7页
Journal of Cardiovascular and Pulmonary Diseases
基金
河北省卫生健康委科研基金项目(20232070)。
