| 曹磊,李晓倩.血清胆碱酯酶联合乳酸清除率对感染性休克患者预后的预测价值.[J].中南医学科学杂志.,2023,(2):265-268. |
| 血清胆碱酯酶联合乳酸清除率对感染性休克患者预后的预测价值 |
| Prognostic value of serum cholinesterase level combined with lactate clearance rate in patients with septic shock |
| 投稿时间：2022-08-01 修订日期：2023-01-20 |
| DOI：10.15972/j.cnki.43-1509/r.2023.02.027 |
| 中文关键词: 血清胆碱酯酶 乳酸清除率 感染性休克 APACHEⅡ评分 预后 [ |
| 英文关键词:serum cholinesterase lactic acid clearance septic shock APACHEⅡ score prognosis |
| 基金项目:安庆市科学技术局自筹经费科技计划项目(2021Z2015) |
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| 中文摘要: |
| 目的探讨血清胆碱酯酶(SChE)水平联合乳酸清除率(LCR)对感染性休克患者预后的预测价值。 方法选取感染性休克患者90例,根据28天预后将患者分为存活组(52例)和死亡组(38例),根据SChE水平分为低SChE组(≤4 000 U/L)和正常SChE组(＞4 000 U/L),根据24 h LCR分为低LCR组(LCR≤10%)和高LCR组(LCR＞10%),记录所有患者一般资料以及感染性休克确诊24 h内血常规、降钙素原(PCT)、肝肾功能、凝血功能和血气分析指标血乳酸(LAC)。 结果与存活组比较,死亡组患者年龄较大,APACHEⅡ评分、部分肝肾功能指标较高,白细胞计数(WBC)、血小板计数(PLT)、SChE、LCR水平较低。多元回归分析结果显示,年龄、APACHEⅡ评分、SChE和LAC为影响感染性休克患者死亡的独立危险因素。ROC曲线分析显示,SChE联合LAC对感染性休克预后的预测效能最高(P＜0.05)。 生存曲线分析显示,低SChE组感染性休克患者累积存活率明显低于正常SChE组(P＜0.05),低LCR组感染性休克患者累积存活率明显低于高LCR组(P＜0.05)。 结论年龄、APACHEⅡ评分、SChE和LAC为感染性休克患者死亡的独立危险因素,SChE和24 h LCR可作为感染性休克患者短期预后的预测指标。 |
| 英文摘要: |
| AimTo investigate the predictive value of serum cholinesterase (SChE) level combined with lactate clearance (LCR) in patients with septic shock (2 cases of lost follow-up). MethodsA total of 92 patients with septic shock were divided into a survival group (52 cases) and a death group (38 cases) according to the 28-day prognosis, and further divided into a low SChE group (≤4 000 U/L) and a normal SChE group (＞4 000 U/L) according to the level of SChE. According to 24 h LCR into low LCR (LCR 10%) and high LCR (LCR＞10%), General data of all patients and blood routine, procalcitonin (PCT), liver and kidney function, blood coagulation function and blood gas analysis index blood lactate (LAC) within 2 day of infectious shock diagnosis were recorded. ResultsCompared with the survival group, the death group patients were older, had higher APACHEⅡ score, some liver and kidney function indicators, and lower white blood cell count (WBC), platelet count (PLT), SChE, and LCR levels. Results of the multiple regression analysis showed that age, APACHEⅡ score, SChE, and LAC were independent risk factors affecting death in patients with septic shock. The ROC curve analysis showed that SChE alone had a weak prognosis value in predicting patients with septic shock, but the AUC predicted combined with LAC was greater than that predicted alone, with a sensitivity of 94.70% and a specificity of 80.80%. Survival curve analysis showed that the cumulative survival rate of infectious shock patients in the low SChE group was significantly lower than that of normal SChE patients (P＜0.05), and that of infectious shock patients in the low LCR group was significantly lower than that of the high LCR group (P＜0.05). ConclusionAge, APACHEⅡ score, SChE and LAC are the independent risk factors for mortality in septic shock patients. SChE and 24 h LCR can be the predictors of short-term outcome in septic shock patients. |
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