摘要
目的探讨外周血乳酸脱氢酶与白蛋白比值(LDH/Alb)、红细胞分布宽度变异系数(RDW-CV)、乳酸对重症肺炎患者预后的预测价值。方法选取2023年6月至2024年6月就诊的重症肺炎患者128例,根据30 d内预后情况分为预后不良组(n=37)和预后良好组(n=91)。收集患者的临床资料,比较两组外周血LDH/Alb、RDW-CV、乳酸水平差异,采用多因素Logistic回归分析影响患者预后的相关因素,受试者工作特征(ROC)曲线分析LDH/Alb、RDW-CV以及乳酸对患者预后的预测价值。结果预后不良组C反应蛋白(CRP)、降钙素原(PCT)、急性生理学和慢性健康状况评价 Ⅱ(APACHE Ⅱ)评分高于预后良好组,氧合指数(OI)、Alb低于预后良好组(P<0.01)。预后不良组外周血LDH/Alb、RDW-CV、乳酸水平均高于预后良好组(P<0.01)。CRP、PCT、APACHE Ⅱ评分、LDH/Alb、RDW-CV、乳酸是影响重症肺炎患者预后的危险因素,而OI、Alb是保护因素(P<0.05,P<0.01)。ROC曲线分析显示,LDH/Alb、RDW-CV以及乳酸联合预测重症肺炎患者预后的曲线下面积为0.867(95%CI:0.803,0.931),敏感度为83.82%,特异度为76.94%。结论重症肺炎患者外周血LDH/Alb、RDW-CV、乳酸水平显著升高,三者联合对患者预后的预测价值较高。
Objective To investigate the predictive value of the lactate dehydrogenase-to-albumin ratio(LDH/Alb)in peripheral blood,red blood cell distribution width-coefficient of variation(RDW-CV),and lactate for the prognosis of patients with severe pneumonia.Methods A total of 128 patients with severe pneumonia who visited the hospital from June 2023 to June 2024 were selected and divided into the poor prognosis group(n=37)and the good prognosis group(n=91)according to the 30-day prognostic outcomes.The clinical data of the patients were collected.The differences in peripheral blood LDH/Alb,RDW-CV and lactate levels between the two groups were compared.Multivariate logistic regression was used to analyze the related factors affecting the prognosis of the patients,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of LDH/Alb,RDW-CV and lactate for the prognosis of the patients.Results C-reactive protein(CRP),procalcitonin(PCT),and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score in the poor prognosis group were higher than those in the good prognosis group,while the oxygenation index(OI)and Alb were lower than those in the good prognosis group(P<0.01).The levels of LDH/Alb,RDW-CV and lactate in the peripheral blood of the poor prognosis group were all higher than those of the good prognosis group(P<0.01).Multivariate logistic regression analysis showed that CRP,PCT,APACHE Ⅱ score,LDH/Alb,RDW-CV,and lactate were risk factors affecting the prognosis of patients with severe pneumonia,while OI and Alb were protective factors(P<0.05,P<0.01).ROC curve analysis showed that the area under the ROC curve of LDH/Alb,RDW-CV and lactate in combination for the prediction of the prognosis of patients with severe pneumonia was 0.867(95%CI:0.803,0.931),with a sensitivity of 83.82%and a specificity of 76.94%.Conclusion The levels of LDH/Alb,RDW-CV and lactate in the peripheral blood of patients with severe pneumonia are significantly increased.The combined detection of the three has a relatively high predictive value for the prognosis of patients.
作者
弓亚雷
张耀之
弓豪杰
杨月
崔波
GONG Yalei;ZHANG Yaozhi;GONG Haojie;YANG Yue;CUI Bo(Department of Respiratory and Critical Care Medicine,Xingtai Central Hospital,Xingtai,Hebei 054000,China;Department of Neurosurgery,Handan Central Hospital,Handan,Hebei 056000,China;Department of Neurology,Handan Central Hospital,Handan,Hebei 056000,China)
出处
《临床误诊误治》
2025年第22期46-51,共6页
Clinical Misdiagnosis & Mistherapy
基金
河北省医学科学研究项目(20191676)。
关键词
重症肺炎
乳酸脱氢酶
白蛋白
红细胞分布宽度变异系数
乳酸
预后
C反应蛋白
氧合指数
severe pneumonia
lactate dehydrogenase
albumin
red blood cell distribution width-coefficient of variation
lactate
prognosis
C-reactive protein
oxygenation index
