摘要
目的:探讨系统免疫炎症指数(SII)及凝血指标联合SOFA评分在尿源性脓毒症早期病情评估中的意义。方法:76例尿源性脓毒症患者,按是否并发脓毒性休克分为脓毒性休克组(n=39)和非脓毒性休克组(n=37)。比较两组患者转入ICU 24 h内的一般临床资料、SII、凝血指标和SOFA评分,采用Logistic回归分析确认患者并发脓毒性休克的危险因素,通过受试者工作特征曲线(ROC)评估独立危险因素单独或联合预测脓毒性休克的价值。结果:(1)脓毒性休克组的SOFA评分、SII、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)和国际标准化比率(INR)高于非脓毒性休克组(均P<0.05)。(2)Logistic回归分析显示SII(OR=3.547,95%CI:1.236~9.668,P=0.018)、APTT延长(OR=6.008,95%CI:1.099~32.853,P=0.039)及SOFA评分(OR=2.122,95%CI:1.197~2.913,P=0.010)为脓毒性休克的独立危险因素。(3)SII、APTT联合SOFA评分预测脓毒性休克的曲线下面积(AUC)为0.900,大于单独使用SII、APTT或SOFA评分的AUC(0.811,0.784,0.816),前者预测脓毒性休克的灵敏度和特异度分别为89.7%和81.1%,优于单一指标。结论:SII、APTT及SOFA评分是尿源脓毒症患者并发脓毒性休克的独立危险因素,SII、APTT联合SOFA评分预测脓毒性休克的发生优于单一指标。
Objective:To explore the significance of systemic immune-inflammation index(SII)and coagulation index combined with sequentialorgan failure assessment(SOFA)score in the early evaluation of sepsis of urinary origin.Methods:A total of 76 patients with sepsis of urinary origin were divided into septic shock group(n=39)and non-septic shock group(n=37)according to whether they were complicated with septic shock.The general clinical data,SII,coagulation index and SOFA score within 24 hours after admission in ICU were compared between the two groups.Logistic regression analysis was used to identify the risk factors of septic shock.Receiver operating characteristic curve(ROC)was used to evaluate the value of independent risk factors alone or combined to predict septic shock.Results:(1)SOFA score,SII,prothrombin time(PT),activated partial thrombin time(APTT)and international standardized ratio(INR)in septic shock group were higher than those in non-septic shock group(all P<0.05).(2)Logistic regression analysis showed that SII(OR=3.547,95%CI:1.236-9.668,P=0.018),APTT prolongation(OR=6.008,95%CI:1.099-32.853,P=0.039)and SOFA score(OR=2.122,95%CI:1.197-2.913,P=0.010)were independent risk factors for septic shock.(3)The area under the curve(AUC)of SII,APTT combined with SOFA score to predict septic shock was 0.900,which was larger than that of AUC scored by SII,APTT or SOFA score alone(0.811,0.784,0.816).The sensitivity and specificity of the former in predicting septic shock were 89.7%and 81.1%,respectively,which were better than that of a single index.Conclusion:SII,APTT and SOFA scores are independent risk factors for septic shock in patients with sepsis of urinary origin.SII,APTT combined with SOFA score is better than a single index in predicting the occurrence of septic shock.
作者
龙启成
温汉春
叶永康
廖品琥
Long Qicheng;Wen Hanchun;Ye Yongkang;Liao Pinhu(Department of Critical Care Medicine,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Emergency Department,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《广西医科大学学报》
CAS
2022年第8期1244-1249,共6页
Journal of Guangxi Medical University
基金
国家自然科学基金项目资助(No.82060022)
广西卫生健康委员会自筹经费科研课题(No.Z20200842)。