摘要
目的探讨尿中性粒细胞明胶酶相关脂质运载蛋白(μNGAL)、内生肌酐清除率(Ccr)、降钙素原联合急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)对脓毒症相关急性肾损伤(SA-AKI)患者生存预后的预测价值。方法回顾性分析2019年7月至2024年6月收治的120例SA-AKI患者,根据28 d生存状态将患者分为生存组79例和死亡组41例,采用多因素logistic分析影响患者生存的因素,并绘制受试者工作特征(ROC)曲线分析μNGAL、Ccr、降钙素原联合APACHEⅡ评分预测SA-AKI患者预后的价值。结果120例SA-AKI患者28 d内病死率为34.17%(41/120)。μNGAL、降钙素原、超敏C反应蛋白、血肌酐水平和APACHEⅡ评分是SA-AKI患者死亡的独立危险因素,Ccr和血清白蛋白水平是患者死亡的保护因素(P<0.05,P<0.01)。μNGAL、APACHEⅡ评分、Ccr、降钙素原水平联合预测患者死亡的曲线下面积大于单独指标预测。结论μNGAL、降钙素原、Ccr水平和APACHEⅡ评分对SA-AKI患者生存预后有一定的预测能力,且联合预测价值最高。
Objective To investigate the predictive value of urinary neutrophil gelatinase-associated lipid carrier protein(μNGAL),endogenous creatinine clearance rate(Ccr),procalcitonin combined with acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ)in survival and prognosis of patients with sepsis-associated acute kidney injury(SA-AKI).Methods A retrospective analysis was performed on 120 patients with SA-AKI admitted from July 2019 to June 2024,and the patients were divided into the survival group(n=79)and the death group(n=41)according to 28-day survival status.Multivariate logistic analysis was used to analyze the factors affecting the survival of the patients.The value ofμNGAL,Ccr,procalcitonin combined with APACHEⅡscore in predicting the prognosis of SA-AKI patients was analyzed by receiver operating characteristic(ROC)curve.Results The 28-day fatality rate of 120 SA-AKI patients was 34.17%(41/120).μNGAL,procalcitonin,hypersensitive C reactive protein,serum creatinine level and APACHEⅡscore were independ-ent risk factors for death in SA-AKI patients,while Ccr and serum albumin levels were protective factors for death in SA-AKI patients(P<0.05,P<0.01).The area under the ROC curve of the combination ofμNGAL,APACHEⅡscore,Ccr,and procalcitonin level to predict death was greater than that predicted by each indicator alone.ConclusionμNGAL,procalcitonin,Ccr level and APACHEⅡscore have certain predictive ability for survival and prognosis of SA-AKI patients,and the combined predictive value is the highest.
作者
崔超
李劭凝
马建华
CUI Chao;LI Shaoning;MA Jianhua(Department of Intensive Care Medicine,the Second Hospital of Shijiazhuang City,Shijiazhuang 050011,China;Department of Geriatrics,Chengde Central Hospital,Chengde,Hebei 067024,China)
出处
《临床误诊误治》
2025年第3期73-77,88,共6页
Clinical Misdiagnosis & Mistherapy
基金
河北省2023年度医学科学研究课题计划(20231630)。
关键词
急性肾损伤
脓毒症
尿中性粒细胞明胶酶相关脂质运载蛋白
内生肌酐清除率
降钙素原
急性生理学与慢性健康状况评分系统Ⅱ
受试者工作特征
预后
Acute kidney injury
Sepsis
Urinary neutrophil gelatinase-associated lipocalin
Endogenous creatinine clearance rate
Procalcitonin
Acute physiology and chronic health evaluation scoring systemⅡ
Receiver operating character-istic
Prognosis
作者简介
崔超,本科,主治医师。主要从事急诊重症医学科、综合内科方向研究;通讯作者:马建华,E⁃mail:majianhua2884567@163.com。
