摘要
目的探讨血小板计数(PLT)、中性粒细胞与淋巴细胞比值(NLR)、血清降钙素原(PCT)对脓毒血症患者预后不良的预测价值,为临床诊疗提供参考。方法选取2022年7月至2024年7月河南省鹤壁市人民医院重症监护室收治的100例脓毒症患者的临床资料进行回顾性分析,根据28 d后的生存结局分为生存组(55例)和死亡组(45例)。比较两组患者白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、急性生理学与慢性健康状况评分系统(APACHEⅡ)评分、血小板计数(PLT)、中性粒细胞与淋巴细胞比值(NLR)。分析PCT、NLR、PLT单独及联合检测预测脓毒血症患者预后不良的价值。结果两组患者年龄、性别、感染部位比较,差异均无统计学意义(P>0.05);死亡组患者WBC、CRP水平、APACHEⅡ评分、NLR、PCT水平均高于生存组,PLT水平低于生存组,差异均有统计学意义(P<0.05)。多因素Logistic分析结果显示,CRP、APACHEⅡ评分、PLT、NLR和血清PCT均是影响脓毒症患者死亡的独立影响因素(P<0.05)。受试者操作特征(ROC)曲线分析结果显示,CRP、APACHEⅡ评分、PLT、NLR、PCT、联合检测预测脓毒症患者28 d生存结局的曲线下面积(AUC)分别为0.763、0.85、0.741、0.869、0.850、0.986(P<0.05)。结论PLT、NLR、血清PCT水平可以一定程度上辅助预测脓毒症患者的预后情况,且CRP、APACHEⅡ、PCT、NLR、PLT联合检测对脓毒症预后的评估效果优于单项检测。
Objective To explore the predictive value of platelet count(PLT),neutrophil-to-lymphocyte ratio(NLR),and serum procalcitonin(PCT)on the poor prognosis of patients with sepsis,providing a reference for clinical diagnosis and treatment.Methods A retrospective analysis was conducted on the clinical data of 100 sepsis patients admitted to the ICU of Hebi People's Hospital from July 2022 to July 2024.Based on the survival outcomes after 28 days,patients were divided into a survival group(55 cases)and a death group(45 cases).White blood cell count(WBC),C-reactive protein(CRP),PCT,Acute Physiology and Chronic Health EvaluationⅡ(APACHE II)score,PLT,and NLR were compared between the two groups.The value of PCT,NLR,and PLT in predicting poor prognosis in sepsis patients was analyzed,both individually and in combination.Results There were no statistically significant differences in age,gender,or infection site between the two groups(P>0.05).The death group had higher levels of WBC,CRP,APACHEⅡscore,NLR,and PCT,and lower levels of PLT compared to the survival group,with all differences being statistically significant(P<0.05).Multivariate logistic analysis showed that CRP,APACHE II score,PLT,NLR,and serum PCT were independent factors affecting mortality in sepsis patients(P<0.05).Receiver Operating Characteristic(ROC)curve analysis indicated that the area under the curve(AUC)for CRP,APACHEⅡscore,PLT,NLR,PCT,and combined detection in predicting 28-day survival outcomes of sepsis patients were 0.763,0.85,0.741,10 Clinical Research,Apr.2025,Vol.33 No.040.869,0.850,and 0.986 respectively(P<0.05).Conclusion PLT,NLR,and serum PCT levels can assist in predicting the prognosis of sepsis patients to some extent.The combined detection of CRP,APACHE II,PCT,NLR,and PLT provides a better assessment of sepsis prognosis compared to single-item detection.
作者
米达
孙屹屹
MI Da;SUN Yiyi(ICU,Hebi People's Hospital,Hebi Henan 458030,China;Department of Critical Care Medicine,Hebi People's Hospital,Hebi Henan 458030,China)
出处
《临床研究》
2025年第4期9-12,共4页
Clinical Research
作者简介
米达,男。研究方向:重症医学方向;通讯作者:孙屹屹,主任医师,sunyyyhua@sohu.com。
