降钙素原联合血小板/淋巴细胞比值对脓毒症28 d死亡预测价值

Predictive Value of Procalcitonin Combined with Platelet/Lymphocyte Ratio on 28 d of Death in Sepsis

目的:分析降钙素原(PCT)联合血小板/淋巴细胞比值(PLR)预测脓毒症28 d死亡的价值。方法:回顾性分析2020年1月-2021年6月惠州市中心人民医院收治的130例脓毒症患者的临床资料,根据患者28 d预后情况分为存活组和死亡组。比较两组患者一般资料及实验室指标,通过logistic回归分析影响脓毒症患者预后的因素,并通过ROC曲线分析PCT、PLR预测脓毒症患者28 d死亡的价值。结果:130例患者中死亡36例,存活94例。死亡组PCT、PLR、急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)评分及序贯器官衰竭(SOFA)评分均高于存活组(P<0.05)。logistic回归分析结果显示,PCT、PLR、APACHEⅡ评分及SOFA评分是影响脓毒症患者预后的独立危险因素(P<0.05)。ROC曲线分析结果显示,PCT联合PLR对脓毒症患者28 d预后的预测价值优于PCT、PLR单独应用,曲线下面积(AUC)为0.862,95%CI(0.772,0.951)。结论:PCT、PLR是脓毒症患者28 d死亡的重要影响因素,在患者28 d死亡预测中具有重要应用价值,且二者联合可进一步提高预测效果,值得临床重视。

Objective: To analyze the predictive value of procalcitonin(PCT) combined with platelet/lymphocyte ratio(PLR) on 28 d of death of sepsis. Method: The clinical data of 130 patients with sepsis admitted to Huizhou Central People’s Hospital from January 2020 to June 2021 were retrospectively analyzed, and the patients were divided into survival group and death group according to their prognosis at 28 d. The general data and laboratory indicators of the two groups were compared, the factors affecting the prognosis of sepsis patients were analyzed by logistic regression, and the predicting value of PCT and PLR in 28 d death of sepsis patients were analyzed by ROC curve. Result: Among the 130 patients, 36 died and 94 survived. PCT, PLR, APACHEⅡ scores and sequential organ failure(SOFA) scores in the death group were higher than those in the survival group(P<0.05).logistic regression analysis showed that PCT, PLR, APACHEⅡ score and SOFA score were independent risk factors affecting the prognosis of sepsis patients(P<0.05). ROC curve analysis showed that PCT combined with PLR was better than PCT and PLR alone in predicting 28 d prognosis of patients with sepsis, area under the curve(AUC) was 0.862, 95%CI(0.772, 0.951). Conclusion: PCT and PLR are important factors affecting the 28 d death of sepsis patients, and have important application value in the prediction of 28 d death of patients, and the combination of the two can further improve the prediction effect, worthy of clinical attention.