动脉血乳酸联合血清淀粉样蛋白A水平对脓毒症患儿发生休克的预测价值

Predictive value of arterial blood lactate combined with serum amyloid A levels for the occurrence of shock in children patients with sepsis

目的 探究动脉血乳酸(Lac)联合血清淀粉样蛋白A(SAA)水平对脓毒症患儿发生休克的预测价值。方法 回顾性分析2020年1月至2023年1月合肥市第二人民医院收治的92例脓毒症患儿的病历资料,根据患儿液体复苏治疗期间是否发生脓毒症休克分为休克组和转归组。筛查脓毒症患儿发生休克的影响因素,评估动脉血Lac、SAA预测脓毒症患儿发生休克的效能。结果 92例脓毒症患儿中进展至脓毒症休克38例(41.30%)。休克组动脉血Lac、SAA、儿科序贯器官衰竭评估(p SOFA)评分高于转归组,格拉斯哥昏迷量表(GCS)评分低于转归组(P<0.05)。动脉血Lac(OR=3.601)、SAA(OR=3.688)、p SOFA评分(OR=3.579)、GCS评分(OR=0.254)是脓毒症患儿发生休克的影响因素(P<0.05)。动脉血Lac、SAA单一及联合预测脓毒症患儿发生休克的曲线下面积分别为0.794、0.809、0.884。结论 动脉血Lac、SAA表达水平与脓毒症患儿发生休克有关,且在预测脓毒症患儿发生休克中的效能良好。

Objective To explore the predictive value of arterial blood lactate(Lac)combined with serum amyloid A(SAA)levels for the occurrence of shock in children with sepsis.Methods A retrospective analysis was conducted on medical records of 92 children patients with sepsis admitted to Hefei Second People’s Hospital from January 2020 to January 2023.They were divided into shock group and conversion group based on the occurrence of septic shock during fluid resuscitation.The influencing factors of the occurrence of shock in children patients with sepsis were screened,and the efficacy of arterial blood Lac and SAA in predicting the occurrence of shock in children patients with sepsis was evaluated.Results Among the 92 children patients with sepsis,38 cases(41.30%)progressed to septic shock.The arterial blood Lac,SAA,and pediatric sequential organ failure assessment(pSOFA)scores in shock group were higher than those in conversion group,while Glasgow coma scale(GCS)score in shock group was lower than that in conversion group(P<0.05).Arterial blood Lac(OR=3.601),SAA(OR=3.688),pSOFA score(OR=3.579),and GCS score(OR=0.254)were the influencing factors for occurrence of shock in children patients with sepsis(P<0.05).The area under the curve of the single and combined prediction of arterial Lac and SAA for occurrence of shock in children patients with sepsis were 0.794,0.809,and 0.884,respectively.Conclusion The expression levels of arterial blood Lac and SAA are related to the occurrence of shock in children patients with sepsis,and they are effective in predicting the occurrence of shock in children patients with sepsis.