摘要
目的探讨血清C反应蛋白(c-reactive protein,CRP)与白蛋白(albumin,ALB)的比值(CRP/ALB ratio,CAR)对恙虫病并发器官功能损伤的预测价值。方法回顾性分析2010年1月1日至2020年12月31日温州医科大学附属第一医院全院收治的166例恙虫病患者的临床资料,根据器官损伤标准分为有器官损伤组(72例)和无器官损伤组(94例)。比较两组患者的一般资料和实验室检查结果,将单因素分析有意义的指标进行多因素Logistic回归分析,采用受试者工作特征(receiver operating characteristic,ROC)曲线和曲线下面积(area under the curve,AUC)分析CAR对恙虫病患者并发器官损伤的预测价值。结果有器官损伤组和无器官损伤组患者年龄、性别、发热天数、入院体温等比较差异无统计学意义(P>0.05)。但有器官损伤组中身体质量指数、急性生理和慢性健康评分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、序贯器官衰竭评估量表(sequential organ failure assessment,SOFA)住院天数、住院费用、中性粒细胞百分比(neutophil,NEUT)、淋巴细胞计数、降钙素原定量、CRP、CAR均高于无器官损伤组(P<0.05),ALB低于无器官损伤组(P<0.05)。多因素Logistic回归分析结果显示,APACHEⅡ(P=0.039)、NEUT(P=0.003)CAR(P=0.011)是恙虫病并发器官功能损伤的独立危险因素。ROC曲线结果显示,APACHEⅡ、NEUT、CAR的AUC分别为0.655、0.716、0.727,CAR截断值为2.86时对应的敏感度为55.6%,特异度为79.8%。结论CAR升高是恙虫病并发器官功能损伤的独立危险因素,可作为评估恙虫病患者有无器官损伤的重要指标。
Objective To explore the predictive value of the serum C-reactive protein(CRP)/albumin(ALB)ratio(CAR)for organ damage in tsutsugamushi disease.Methods The clinical data of 166 patients with tsutsugamushi disease admitted to the First Affiliated Hospital of Wenzhou Medical University from January 1,2010 to December 31,2020 were retrospectively analyzed.The patients were divided into the organ damage group(72 cases)and non-organ damage group(94 cases)according to the organ damage criteria.The general data and laboratory test results of the two groups of patients were compared.The significant indicators of univariate analysis were analyzed by multivariate logistic regression analysis.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the predictive value of CAR for organ damage in patients with tsutsugamushi disease.Results There were no significant differences in age,sex,days of fever,and admission body temperature between the organ damage group and non-organ damage group(P>0.05).However,the body mass index,acute physiology and chronic health evaluationⅡ(APACHEⅡ),sequential organ failure assessment(SOFA),length of hospital stay,hospitalization expense,percentage of neutrophils(NEUT),lymphocyte count,procalcitonin,CRP,and CAR in the organ damage group were significantly higher than those in the non-organ damage group(P<0.05),and ALB was significantly lower than that in the non-organ damage group(P<0.05).Multivariate logistic regression analysis showed that APACHE Ⅱ(P=0.039),NEUT(P=0.003),and CAR(P=0.011)were independent risk factors for tsutsugamushi disease complicated by organ damage.The ROC curve showed that the AUCs of APACHEⅡ,NEUT,and CAR were 0.655,0.716,and 0.727,respectively.When the cut-off value of CAR was 2.86,the sensitivity was 55.6%,and the specificity was 79.8%.ConcIusions Elevated CAR is an independent risk factor for tsutsugamushi disease complicated with organ damage and can be used as an important indicator to evaluate the presence or absence of organ damage in patients with tsutsugamushi disease.
作者
刘金壹
赵光举
宋文静
洪广亮
唐亚慧
陈隆望
吴斌
支绍册
卢中秋
Liu Jinyi;Zhao Guangju;Song Wenjing;Hong Guangliang;Tang Yahui;Chen Longwang;Wu Bin;Zhi Shaoce;Lu Zhongqiu(Emergency Department,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;Wenzhou Key Laboratory of emergency and disaster medicine,Wenzhou 325000,China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2022年第6期804-808,共5页
Chinese Journal of Emergency Medicine
基金
浙江省重点研发计划项目(2021C03072)
浙江省医学创新学科计划项目(11-CX26)
浙江省“十三五”中医药重点专科(急诊科)建设项目
温州市急危重病与救援医学重点实验室建设项目。
