预后营养指数对急性肺栓塞患者预后的预测价值

Prognostic value of prognostic nutritional index in patients with acute pulmonary embolism

目的探讨预后营养指数(PNI)对急性肺栓塞患者预后的预测价值。方法回顾性收集2013年8月-2019年8月西南医科大学附属医院收治的206例急性肺栓塞患者的临床资料,包括一般资料、既往病史、血常规及肝肾功能等。根据患者预后情况分为死亡组48例和存活组158例,计算PNI。比较患者一般资料的组间差异,采用多因素Logistic回归分析各相关因素与急性肺栓塞预后的关系;采用受试者工作特征曲线评估PNI对急性肺栓塞患者预后的预测价值。结果两组患者的年龄、淋巴细胞数、红细胞数、血红蛋白、白蛋白、前白蛋白及PNI比较,差异有统计学意义(P<0.05)。前白蛋白[OR^(^)=1.009(95%CI:1.002,1.016)]和PNI[OR^(^)=1.246(95%CI:1.050,1.478)]是预测急性肺栓塞患者预后的影响因素。前白蛋白的敏感性为63.92%(95%CI:0.566,0.712),特异性83.33%(95%CI:0.760,0.906);PNI的敏感性为87.34%(95%CI:0.808,0.938),特异性66.67%(95%CI:0.602,0.731)。结论PNI是一个新的急性肺栓塞预后的独立影响因素,对肺栓塞患者的预后有一定的预测价值。

Objective To explore the value of prognostic nutritional index in patients with acute pulmonary embolism.Methods The clinical data of 206 patients with acute pulmonary embolism who were treated in southwest medical university affiliated hospital from August 2013 to August 2019 were retrospectively collected.The patients were divided into death group and survival group according to their prognosis.Calculation of PNI.X2 test and t test were used to compare the differences between the two groups,and multivariate logistic regression analysis and receiver operating characteristic(ROC)curve were used to evaluate the prognostic value of PNI in patients with APE.Results There were significant differences in age,lymphocyte number,RBC number,hemoglobin,albumin,and prealbumin between the two groups(P<0.05).PNI[OR^(^)=1.246,(95%CI:1.050,1.478)]and prealbumin[OR^(^)=1.009,(95%CI:1.002,1.016)]were the predictors of prognosis in patients with acute pulmonary embolism.The sensitivity and specificity of PNI were 87.34%(95%CI:0.808,0.938)and 66.67%(95%CI:0.602,0.731),and the sensitivity and specificity of prealbumin were 63.92%(95%CI:0.566,0.712)and 83.33%(95%CI:0.760,0.906).Conclusion PNI is a new independent prognostic factor for patients with acute pulmonary embolism.