血清白蛋白联合SNAPPE-Ⅱ在早产儿感染病情及预后中的预测价值

Predictive value of serum albumin combined with SNAPPE-Ⅱ ininfection and prognosis of premature infants

目的 探讨血清白蛋白(albumin,ALB)水平、新生儿急性生理评分(score for neonatal acute physiology with perinatal extension,SNAPPE)-Ⅱ对早产儿感染病情及预后的预测价值。方法 回顾性选择感染早产儿为感染组(n=46)、同期无感染者为对照组(n=36)。比较并分析ALB、SNAPPE-Ⅱ及二者联合对预测两组早产儿感染的价值。结果 两组住院时间、吸氧时间、机械通气时间、无创正压通气时间以及静脉营养时间差异显著(P<0.05)。两组ALB、SNAPPE-Ⅱ差异均有统计学意义(P<0.05)。多因素非条件logistic分析结果显示,住院时间、吸氧时间、机械通气时间、无创正压通气时间、静脉营养时间及SNAPPE-Ⅱ是早产儿感染发生的独立危险因素(P<0.05),ALB水平是早产儿感染发生的独立保护因素(P<0.05)。SNAPPE-Ⅱ对早产儿感染进行受试者工作特征曲线分析,ALB、SNAPPE-Ⅱ及二者联合诊断早产儿感染曲下面积分别为0.761、0.738、0.893,二者联合效能最高。结论 血清ALB、SNAPPE-Ⅱ对早产儿感染预后诊断均具有较佳价值,且二者联合效果更好,可帮助指导合理、及时进行抗菌药物治疗,改善预后。

Objective To investigate the predictive value of serum albumin(ALB)level and score for neonatal acute physiology with perinatal extension(SNAPPE)-Ⅱin infection and prognosis of premature infants.Methods The infected premature infants were selected as the infected group(n=46)and the control group without infected infants(n=36).The value of ALB,SNAPPE-Ⅱand their combination in predicting the infection of preterm infants in two groups were compared and analyzed.Results There were significant differences in hospitalization time,oxygen inhalation time,mechanical ventilation time,non-invasive positive pressure ventilation time,and intravenous nutrition time between the two groups(P<0.05).The differences in ALB and SNAPPE-Ⅱbetween the two groups were statistically significant(P<0.05).The results of multivariate unconditional logistic analysis showed that hospitalization time,oxygen inhalation time,mechanical ventilation time,non-invasive positive pressure ventilation time,intravenous nutrition time,and SNAPPE-Ⅱwere independent risk factors for premature infant infection(P<0.05),and ALB level was an independent protective factor for premature infant infection(P<0.05).receiver operating characteristic curve analysis of SNAPPE-Ⅱ for premature infant infection showed that the area under the curve of ALB, SNAPPE-Ⅱ, and their combination fordiagnosing premature infant infection were 0.761, 0.738, and 0.893, respectively, the combination of the two showedthe highest efficacy. Conclusion Serum ALB and SNAPPE-Ⅱ have better value in prognosis diagnosis of infection inpremature infants, and their combined effect is better, which can guide rational and timely antimicrobial therapy andimprove prognosis.