血浆游离脂肪酸与三酰甘油的比值预测脓毒症患者预后的价值

Prognostic value of plasma free fatty acid to triglyceride ratio in patients with sepsis

目的 探讨血浆游离脂肪酸(plasma free fatty acid,FFA)与三酰甘油(triglyceride,TG)比值在预测脓毒症患者预后中的价值。方法 收集2019年1月至2020年12月因脓毒症收治湖州市中心医院重症医学科的患者78例,统计患者的信息及实验室指标,根据患者预后将其分为存活组(n=40)和死亡组(n=38),比较两组患者基线资料与实验室指标的差异,筛选出影响预后的单因素指标,进行Logistic回归分析及受试者操作特征(receiver operator characteristic,ROC)曲线分析。结果 单因素分析结果显示,死亡组患者APACHE-Ⅱ评分、FFA及FFA/TG显著高于存活组(P<0.001),TG、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇组间比较,差异无统计学意义(P分别为0.215、0.992、0.124、0.695),两组其他基线资料比较,差异无统计学意义。多因素Logistic分析显示,APPACHE-Ⅱ评分、FFA、FFA/TG是影响脓毒症患者预后的独立危险因素(P<0.05),ROC曲线下面积(area under the curve,AUC)分别为(0.721±0.058)、(0.755±0.056)、(0.836±0.044),均P<0.001,FFA/TG在预测脓毒症患者预后方面优于APPACHE-Ⅱ和FFA。结论 脓毒症患者存在脂质代谢紊乱,FFA/TG在预测脓毒症患者的预后价值优于APPACHE-Ⅱ评分,且比值越高预后越差。

Objective To investigate the value of plasma free fatty acid(FFA)and triglyceride(TG)ratio in predicting the prognosis of sepsis.Methods Electronic case information of all patients with sepsis admitted to the Department of Intensive Care Unit Huzhou Central Hospital from January 2019 to December 2020 was collected,and patients meeting the diagnostic criteria for sepsis were included.The patient’s ICU case information and laboratory test data were collected,and the patients were divided into two groups according to their prognosis:survival group(n=40)and death group(n=38).The differences of baseline data and laboratory indexes were compared between the two groups,and the single factor indexes affecting prognosis were screened out for Logistic regression analysis and receiver operator characteristic(ROC)curve analysis.Results In univariate analysis,APPACH-Ⅱscore,FFA and FFA/TG in death group were significantly higher than those in survival group(P<0.001),and TG,total cholesterol,high density lipoprotein and low density lipoprotein showed no significant difference between the two groups(P=0.215,0.992,0.124 and 0.695,respectively).There was no statistically significant difference in the companion of other baseline data between two groups.Multivariate Logistic analysis showed that APPACH-Ⅱscore,FFA and FFA/TG were the independent risk factors affecting the prognosis of sepsis patients(P<0.05).Area under the curve(AUC)of ROC curev was used to evaluate the predictive value of APPACHE-Ⅱscore,FFA and FFA/TG(0.721±0.058)(0.755±0.056),(0.836±0.044),all P<0.001.FFA/TG was superior to APPACHE-Ⅱand FFA in predicting the prognosis of patients with sepsis.Conclusion Lipid metabolism disorders exist in patients with sepsis.The prognostic value of FFA/TG in predicting sepsis patients is better than that of APPACHE-Ⅱscore,and the higher the ratio,the worse the prognosis.