胆碱酯酶联合CLI对感染性休克患者预后的预测价值

Prognostic Value of Capillary Leakage Index Combined with Complement SChE in Early Stage of Sepsis in Children

目的:探讨胆碱酯酶(SChE)联合毛细血管渗漏指数(CLI)对感染性休克患者预后的预测价值。方法:回顾性分析2022年12月至2024年4月我院收治的60例感染性休克患者,根据转归分为预后良好组和预后不良组,采用logistic回归分析患者预后不良的独立危险因素,采用ROC曲线分析两者预测患者预后不良的价值。结果:预后不良组呼吸机使用率、SOFA和APACHE评分、CRP和PCT以及CLI均明显高于预后良好组,而SChE、IgM、总T淋巴细胞降低(P<0.05)。SChE与SOFA、APACHE评分呈负相关(r=-0.551和-0.624,P=0.000),而CLI与SOFA、APACHE评分呈正相关(r=0.469和0.742,P=0.000)。Logistic回归分析显示,CLI、APACHE和SOFA评分越高、SChE越低是患者预后不良的独立因素。ROC曲线显示,SChE和CLI联合预测的AUC为0.833,约登指数为0.415,两者联合的预测价值明显高于单项指标(P<0.05)。结论:感染性休克患者CLI水平明显升高而SChE水平降低,可作为感染性休克诊断及预后评价的指标,且两者联合具有较高的预测价值。

Objective:To investigate the prognostic value of SChE and CLI in patients with septic shock.Methods:60 patients with septic shock admitted to our hospital were retrospectively analyzed and divided into good prognosis group and poor prognosis group according to the outcome.logistic regression was used to analyze the independent risk factors of poor prognosis of patients,and ROC curve was used to analyze the value of both in predicting poor prognosis of patients.Results:The utilization rate of ventilator,SOFA and APACHE scores,CRP,PCT and CLI in the poor prognosis group were significantly higher than those in the good prognosis group,while SChE,IgM and total T lymphocytes were decreased(P<0.05).SChE was negatively correlated with SOFA and APACHE scores(r=-0.551 and-0.624,P=0.000),while CLI was positively correlated with SOFA and APACHE scores(r=0.469 and 0.742,P=0.000).Logistic regression analysis showed that the higher the score of CLI,APACHE and SOFA and the lower the SChE were independent factors of poor prognosis.The ROC curve showed that the AUC of SChE and CLI combined forecast was 0.833 and the Yoden index was 0.415,and the combined forecast value was significantly higher than that of the single index(P<0.05).Conclusion:The CLI level is significantly increased and SChE level is decreased in septic shock patients,which can be used as an indicator for diagnosis and prognosis evaluation of septic shock,and the combination of the two has high predictive value.