24h LCR、SOFA评分及SAPS Ⅱ评分在腹腔感染致脓毒症患者预后评估中的作用

The role of 24h LCR, SOFA score and SAPS Ⅱ score in the prognosis evaluation of sepsis induced by abdominal infection

目的:分析24小时乳酸清除率(24 h LCR)、序贯器官衰竭评分(SOFA评分)及简化急性生理评分(SAPSⅡ评分)在腹腔感染致脓毒症患者预后评估中的作用。方法:选择2014年3月~2015年9月我院收治的脓毒症患者37例,根据预后将患者分为两组,存活组(28例)和死亡组(9例)。运用受试者工作特征曲线(ROC)比较24 h LCR、降钙素原(PCT)、SOFA评分、SAPSⅡ评分在腹腔感染致脓毒症患者预后评估中的效能并探讨它们之间的关系。结果:①死亡组患者PCT、SOFA评分及SAPSⅡ评分明显高于存活组患者,差异具有统计学意义;死亡组患者24 h LCR低于存活组患者,差异具有统计学意义。②24 h LCR、PCT、SOFA评分及SAPSⅡ评分在预测腹腔感染致脓毒症患者预后方面均有很大的价值,各指标ROC曲线下面积比较,差异均不具统计学意义。③24 h LCR与PCT呈负相关;SOFA评分与PCT呈正相关;SOFA评分与SAPSⅡ评分呈正相关。结论:24 h LCR、PCT、SOFA评分及SAPSⅡ评分在腹腔感染致脓毒症患者预后评估中具有重要意义。

Objective The effects of 24 hours lactate clearance rate(24 h LCR),sequential organ failure score(SOFA score)and Simplified Acute Physiology Score(SAPS II score)on prognosis of sepsis patients after abdominal infection were analyzed.Methods In March 2014 to September 2015,the patients with sepsis treated in ICU were divided into two groups according to the prognosis,the survival group(28 cases)and the death group(9 cases).The receiver operating characteristic curve(ROC)was used to compare the efficacy of 24 h LCR,procalcitonin(PCT),SOFA score and SAPS II score in the prognosis evaluation of sepsis patients induced by abdominal infection,and to explore the relationship between them.Results①The scores of PCT,SOFA and SAPS II in the death group were significantly higher than those in the survival group,the difference was statistically significant,and the 24 h LCR in the death group was lower than that in the survival group,the difference was statistically significant.②24 h LCR,PCT,SOFA score and SAPS II score have great value in predicting the prognosis of sepsis patients caused by abdominal infection.There is no statistically significant difference in the area under the ROC curve of each index.③24 h LCR was negatively correlated with PCT;SOFA score was positively correlated with PCT;SOFA score was positively correlated with the score of SAPS II.Conclusion 24 h LCR,PCT,SOFA score and SAPS II score are of great significance in evaluating the prognosis of patients with sepsis caused by abdominal infection.