NLR比值、APACHEⅢ评分、SOFA评分在急诊脓毒症患者预后评估中的价值

The value of NLR ratio,APACHEⅢscore and SOFA score in the prognostic evaluation of emergency sepsis patients

目的探讨急性生理与慢性健康状况评分系统Ⅲ(APACHEⅢ)、序贯器官衰竭评分(SOFA)、中性粒细胞/淋巴细胞比值(NLR)在急诊脓毒症患者预后评估中的临床价值。方法选取东方市人民医院2017年6月-2019年6月确诊的脓毒症患者100例,根据脓毒症患者入院28 d后预后情况被分为存活组和死亡组,另选取同期健康体检者30人作为对照组。比较对照组与脓毒症组、存活组与死亡组APACHEⅢ评分、SOFA评分、NLR比值差异;ROC曲线分析比较APACHEⅢ、SOFA评分、NLR比值预测脓毒症患者预后的准确性。结果脓毒症组患者APACHEⅢ评分、SOFA评分、NLR比值较对照组显著升高,差异有统计学意义(P<0.05);脓毒症死亡组APACHEⅢ评分、SOFA评分、NLR比值均较存活组显著增加,差异有统计学意义(P<0.05);APACHEⅢ、SOFA、NLR评价脓毒症患者预后的曲线下面积(AUC)分别为0.828、0.770、0.702,APACHEⅢ、SOFA、NLR三者联合检测AUC值为0.874。结论APACHEⅢ、SOFA、NLR评价脓毒症患者预后能力为APACHEⅢ最优,其次为SOFA评分、NLR比值,且APACHEⅢ、SOFA、NLR三者联合预测能力优于单独预测。

Objective To explore the clinical value of acute physiology and chronic health evaluation systemⅢ(APACHEⅢ),sepsis-related organ failure assessment(SOFA),and neutrophil/lymphocyte ratio(NLR)in the prognosis of patients with emergency sepsis.Methods The clinical data of 100 patients diagn with sepsis in our hospital from June 2017 to June2019 were retrospectively analyzed,and 30 patients who passed the physical examination at the same period were selected as the normal group.The differences in APACHEⅢ,SOFA scores,and NLR ratios between the normal group and the sepsis group were compared.According to the prognosis of patients with sepsis 28 d after admission,they were divided into survival and death groups,and the APACHEⅢ,SOFA scores,and NLR of the survival and death groups were compared.Ratio difference and ROC curve analysis were used to compare the accuracy of the three systems in predicting the prognosis of patients with sepsis.Results The APACHEⅢscore,SOFA score,and NLR ratio of the sepsis patients were significantly higher than those of normal group,and the differences were statistically significant(P<0.05).The APACHEⅢscore,SOFA score,and NLR ratio of the sepsis death group were significantly different form those of the surviving group(P<0.05).The AUC value of APACHEⅢin evaluating sepsis patients was 0.828,the AUC value of SOFA was 0.770,the AUC value of NLR was 0.702,and the APACHEⅢ,SOFA,NLR combined detection AUC value was 0.874.Conclusions APACHEⅢ,SOFA,and NLR were used to evaluate the prognosis of sepsis patients;APACHEⅢwas the best,followed by SOFA score and NLR ratio.The combined predictive ability of APACHEⅢ,SOFA,and NLR was better than the single prediction.