恙虫病患者血清白蛋白降低相关因素分析

Analysis of related factors of serum albumin reduction in patients with tsutsugamushi disease

目的研究恙虫病患者血清白蛋白(ALB)浓度的相关影响因素。方法分析395例恙虫病患者的年龄、发水平的相关性,并采用LASSO法进行多因素回归分析。结果ALB水平与年龄的相关系数为-0.337(P<0.001)。入院时ALB水平与丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、球蛋白(GLO)、总胆红素(TBIL)、肌酐(CREA)、白细胞(WBC)、血小板(PLT)、血红蛋白(HGB)等的相关系数分别为-0.100、-0.248、-0.003、-0.349、-0.315、-0.325、0.390和0.355(P分别为0.046、<0.001、0.950、<0.001、<0.001、<0.001、<0.001和<0.001),ALB水平还与入院前发病时间之间存在一定的相关性(r=-0.192,P<0.001)。采用LASSO法回归分析,Lambda.min(log)为0.051(-2.976 2)时,得到最简模型ALB=-0.061 19×AGE-0.001 74×AST-0.019 7×TBIL-0.388 04×WBC+0.018 06×PLT+0.064 67×HGB-0.115 3×发病时间。结论恙虫病患者入院时血清白蛋白降低的主要相关因素是WBC、发病时间、HGB水平和年龄。

Objective To study the serum albumin(ALB)concentration and related influencing factors in tsutsugamushi patients. Methods A total of 395 cases of tsutsugamushi disease were retrospectively analyzed. The correlations between age,time of onset,liver and kidney function,and blood cell counts were compared with ALB levels on admission.Multivariate regression analysis of ALB level at admission and related indicators was performed by LASSO method. Results The correlation coefficient between ALB level and age was ?0.337(P<0.001). The correlation coefficients of ALB levels on admission and alanine aminotransferase(ALT),aspartate transaminase(AST),globulin(GLO),total bilirubin(TBIL),creatinine(CREA),white blood cell(WBC),platelet(PLT)and hemoglobin(HGB)were-0.100,-0.248,-0.003,-0.349,-0.315,-0.325,0.390 and 0.355,respectively(P=0.046,<0.001,0.950,<0.001,<0.001,<0.001,<0.001 and <0.001,respectively). There was a certain correlation between ALB levels and the time of onset before admission(Toba)(r=-0.192,P<0.001). The simplest model by LASSO method was:ALB=-0.061 19×AGE-0.001 74×AST-0.019 7×TBIL-0.388 04×WBC+0.018 06×PLT+0.064 67×HGB-0.115 3× Toba,while the Lambda.min(log)was 0.051(-2.976 2). Conclusion The main correlative factors of serum ALB reduction in patients with tsutsugamushi disease are WBC,onset time,HGB and age.