清蛋白浓度变化与脓毒症预后的关系分析

Analysis of the correlations between the changes in albumin concentration and prognosis of sepsis

目的探讨清蛋白(ALB)浓度变化与脓毒症预后的关系。方法回顾性选取2019年1~11月昆明医科大学第六附属医院以脓毒症收住的84例患者资料,根据预后分为生存组(60例)和死亡组(24例)。采用Logistic回归模型分析两组入院时最低ALB值、首末次ALB差与患者预后的关联;绘制受试者工作曲线(ROC),约登指数选取最佳临界点。结果两组最高、最低、末次ALB和首末次ALB浓度差比较,差异均有统计学意义(P<0.05)。最低ALB的诊断灵敏度为78.3%,特异度为70.8%,临界值为24.1 g/L;首末次ALB浓度差诊断灵敏度为81.3%,特异度为45.8%,临界值为-2 g/L。结论ALB浓度变化与脓毒症患者不良预后相关,当最低ALB<24.1 g/L且首末次ALB差值小于-2 g/L时,脓毒症患者存在较高死亡风险。

Objective To explore the correlations between the changes in albumin(ALB)concentration and prognosis of sepsis.Methods Clinical information of 84 sepsis patients who were admitted to the Sixth Affiliated Hospital of Kunming Medical University between January and November 2019 was retrospectively analysis.The patients were divided into the survival group(60 cases)and the death group(24 cases)in line with the prognosis.Logistic regression model was used to study the correlations between patient prognosis and the lowest ALB value at admission as well as the difference between the initial and the final ALB values.The receiver operating characteristic curve(ROC)was drawn and the optimal cutoff point was selected through Youden index.Results For both the survival group and the death group,the differences in the highest ALB value,the lowest ALB value,the final ALB value and the difference between the initial and the final ALB concentration values were statistically significant(P<0.05).For the lowest ALB value,the diagnostic sensitivity was 78.3%,the specificity was 70.8%and the critical value was 24.1 g/L;for the difference between the initial and the final ALB concentration values,the diagnostic sensitivity was 81.3%,the specificity was 45.8%and the critical value was-2 g/L.Conclusion The changes in ALB concentration are correlated to the poor prognosis of sepsis patients.When the lowest ALB concentration falls below 24.1 g/L and the difference between the initial and the final ALB values is less than-2 g/L,the mortality of sepsis patients is relatively high.