重度烧伤患者早期血浆白蛋白水平联合qSOFA评分对脓毒血症预后的评估价值

Value of Early Plasma Albumin Level Combined with qSOFA Scores in Evaluating the Prognosis of Sepsis in Patients with Severe Burns

目的 :了解血浆白蛋白与脓毒血症之间的关系,探讨白蛋白联合qSOFA评分对脓毒血症患者预后快速评估的效果,为烧伤病人脓毒血症治疗效果的实时检测提供可行的临床指标。方法:收集2014年10月—2017年3月我院烧伤科收治的重度烧伤患者71例,分为脓毒血症组和无脓毒血症组,记录研究人群的入院当天、7、14天的血浆白蛋白及qSOFA。结果 :脓毒血症组住院天数、烧伤总面积、手术次数均高于无脓毒血症组,差异有统计学意义(P <0.05);脓毒血症组的血浆白蛋白与烧伤面积和手术次数之间存在相关性(P <0.05),相关系数分别为-0.274、0.251;住院7天、14天,脓毒血症组血清白蛋白、qSOFA评分均高于无脓毒血症组,差异有统计学意义(P <0.05);7天时,ROC曲线分析白蛋白联合qSOFA评分预测的灵敏度88.6%和特异度79.0%比qSOFA评分单独预测更有效(P <0.05);14天时白蛋白联合qSOFA评分预测的灵敏度89.5%和特异度79.3%比qSOFA评分单独预测更有效(P <0.05)。结论:血浆白蛋白与重度烧伤患者的烧伤严重程度存在相关性,白蛋白联合q SOFA能较好反映脓毒血症患者的预后。两个指标的动态实时监测结果,对脓毒血症的辅助诊断及预测脓毒血症预后有临床指导意义。

Objective:To understand the relationship between plasma albumin and sepsis,and to explore the effect of albumin combined with qSOFA scores on the rapid evaluation of prognosis in patients with sepsis to provide feasible clinical indexes for real-time detection of the therapeutic effect on sepsis in burn patients.Methods:71 patients with severe burns admitted to our hospital from October 2014 to March 2017 were enrolled and divided into a sepsis group and a non-sepsis group.The plasma albumin and qSOFA were recorded on the day of admission,7 days and 14 days after admission.Results:The number of days of hospitalization,total burn area and operation times in the sepsis group were higher than those in the non-sepsis group,and the differences were statistically significant(P<0.05).The level of plasma albumin was correlated with burn area and operation times in the sepsis group(P<0.05),and the correlation coefficients were-0.274 and 0.251,respectively.The level of serum albumin and qSOFA scores 7 days and 14 days after hospitalization in the sepsis group were higher than those in the nonsepsis group,and the differences were statistically significant(P<0.05).On the 7 th day,the sensitivity of the ROC curve for analyzing albumin combined with qSOFA scores was 88.6%and the specificity was 79.0%,indicating that albumin combined with qSOFA scores was more effective than qSOFA scores alone(P<0.05).On the 14 th day,the prediction sensitivity of albumin combined with qSOFA scores was 89.5%and the specificity was 79.3%,indicating that albumin combined with qSOFA scores was more effective than qSOFA scores alone(P<0.05).Conclusion:There is a correlation between plasma albumin and burn severity in patients with severe burns.Albumin combined with qSOFA can better reflect the prognosis of patients with sepsis.The dynamic real-time monitoring results of the two indexes have clinical guiding significance in the auxiliary diagnosis of sepsis and the prognosis of sepsis.