血清肌酸激酶同工酶联合血乳酸预测多发伤患者短期预后的价值

Value of Serum Creatine Kinase Isoenzyme Combined with Blood Lactic Acid on Predicting Short-Term Prognosis in Patients with Multiple Trauma

目的:分析血清肌酸激酶同工酶(CK-MB)联合血乳酸预测多发伤患者短期预后的价值。方法:将2020年1月至2023年12月于本院就诊的119例多发伤患者为研究对象,依据28d的预后情况分为存活组(n=99)和死亡组(n=20)。入院后测定所有研究对象的血清CK-MB及血乳酸水平,以二元Logistic回归分析法构建以CK-MB及血乳酸为变量的预测模型,以受试者特征工作曲线(ROC)分析血清CK-MB及血乳酸水平对患者短期预后的预测价值。结果:死亡组的血清CK-MB及血乳酸水平高于存活组(P<0.05);Logistic回归分析结果显示,CK-MB及血乳酸为多发伤患者短期预后的独立预测指标,预测模型为logit(P)=-6.789+0.188×CK-MB+0.234×血乳酸;ROC曲线分析结果显示,血清CK-MB及血乳酸水平联合预测多发伤患者短期预后的曲线下面积(AUC)为0.997,灵敏度为100.00%,特异度为98.99%,优于各指标单独预测(P<0.05)。结论:血清CK-MB及血乳酸水平与多发伤患者的短期预后密切相关,早期检测CK-MB、血乳酸水平对多发伤患者的短期预后具有一定的预测价值,且各指标联合预测的效能更佳。

Objective:To analyze the value of serum creatine kinase isoenzyme(CK-MB)combined with blood lactic acid on the prediction of short-term prognosis in patients with multiple trauma.Methods:Totally 119 patients with multiple trauma in the hospital were collected from January 2020 to December 2023 as the study subjects,and were divided into survival group(n=99)and death group(n=20)by means of 28-day prognosis status.Serum CK-MB and blood lactic acid levels of all subjects were measured after admission.The prediction model with CK-MB and blood lactic acid as variables was constructed by binary Logistic regression analysis.Receiver operating characteristic curve(ROC)was performed to analyze the predictive value of serum CK-MB and blood lactic acid on short-term prognosis of patients.Results:The levels of serum CK-MB and blood lactic acid in the death group were higher than those in the survival group(P<0.05).Logistic regression analysis indicated that CK-MB and blood lactic acid were independent predictors of short-term prognosis in patients with multiple trauma,and the prediction model was logit(P)=-6.789+0.188×CK-MB+0.234×blood lactic acid.ROC curve analysis showed that the area under the curve(AUC),sensitivity and specificity of serum CK-MB combined with blood lactic acid in predicting the short-term prognosis were 0.997,100.00%and 98.99%,which were better than each indicator alone(P<0.05).Conclusion:Serum CK-MB and blood lactic acid are closely related to the short-term prognosis in patients with multiple trauma.Early detection of CK-MB and blood lactic acid levels has certain predictive value on the short-term prognosis of patients with multiple trauma,and the combined prediction of the two indicators is more effective.