尿膿毒癥C反應蛋白/白蛋白比值與其病情和短期預后的關系分析

張劍　潘劍峰　江穎鏘

【摘要】 目的：探討尿膿毒癥C反應蛋白/白蛋白比值（CAR）與其病情和短期預后的關系。方法：選取2015年1月-2016年12月本院收治的尿膿毒癥患者80例為研究對象。觀察治療前后的CAR、APACHE Ⅱ評分和28 d病死率。比較不同預后的CAR和APACHE Ⅱ評分，分析其CAR與APACHE Ⅱ評分和28 d病死率的關系，并采用ROC曲線分析治療前后的CAR預測其28 d病死率的價值。結果：與治療前比較，治療后的CAR和APACHE Ⅱ評分均降低（P<0.05），患者28 d病死率為8.75%。與存活患者比較，死亡患者治療前后的CAR和APACHE Ⅱ評分均升高（P<0.05）。Spearman無條件相關分析結果顯示，尿膿毒癥患者CAR與APACHE Ⅱ評分和28 d病死率均呈正相關（r=0.826、0.853，P<0.05）。ROC曲線分析結果顯示，尿膿毒癥患者治療前后的CAR預測其28 d病死率的價值良好，其中以治療后的CAR預測其28 d病死率的價值最優。結論：尿膿毒癥患者CAR較高與其其病情和預后相關，可能作為其病情和預后評估的參考指標。

【關鍵詞】 尿膿毒癥； C反應蛋白/白蛋白比值； 病情； 短期預后； 關系

【Abstract】 Objective：To investigate the relationship between C reactive protein/albumin ratio（CAR） and its severity with short-term prognosis in patients with urinary sepsis.Method：80 cases of patients with urinary sepsis in our hospital from January 2015 to December 2016 were selected as the research objects.Before and after treatment CAR，APACHE Ⅱ score and 28 day mortality of were observed.Bbefore and after treatment，the CAR，APACHE Ⅱ score of patients with different prognosis were compared，and the relationship between CAR with APACHE Ⅱ score and 28 day mortality rate were analyzed，the ROC curve was used to analyze the value of CAR before and after treatment.Result：Compared with before treatment，the CAR and APACHE Ⅱ score of after treatment were decreased（P<0.05）.The 28 day mortality rate of the patients was 8.75%.Compared with the surviving patients，the CAR and APACHE Ⅱ scores were higher before and after treatment（P<0.05）.Spearman unconditional correlation analysis results showed that CAR was positively correlated with APACHE Ⅱ score and 28 day mortality in patients with urinary sepsis（r=0.826，0.853；P<0.05） .ROC curve analysis results showed that value of the before and after treatment CAR of patients with urinary sepsis predicting the 28 day mortality was good，in which the value of after treatment CAR predicting the 28 day mortality was better.Conclusion：CAR of patients with urinary sepsis is related to the disease severity and prognosis，which may be used as reference index for the evaluation of disease severity and prognosis of patients with urinary sepsis.

【Key words】 Urinary sepsis； C reactive protein/albumin ratio； Disease； Short term prognosis； Relationship

First-authors address：The Fifth Peoples Hospital of Nanhai District of Foshan，Foshan 528211，China

doi：10.3969/j.issn.1674-4985.2017.25.030

泌尿系統感染為臨床常見病癥，若無及時有效干預，可導致嚴重泌尿系統感染寄尿膿毒癥的發生，病情兇險且變化快，治療困難，嚴重危及患者健康和生命安全[1-3]。因此，其對尿膿毒癥病情和預后具有重要意義。尿膿毒癥為感染性疾病，而C反應蛋白、白蛋白均與感染密切相關[4-7]。因此CRP、ALB可能與尿膿毒癥相關，可能用于其病情變化評估，而C反應蛋白/白蛋白比值（C reactive protein/albumin ratio，CAR）綜合了兩個因子變化，可能更有利于評估其病情和預后。為此，本研究檢測了尿毒癥患者的CAR，并分析了其與病情指標和短期預后指標的關系及其對患者短期預后的評估價值，旨在為尿膿毒癥的病情和預后評估干預提供指導，現報道如下。endprint

1 資料與方法

1.1 一般資料 選取2015年1月-2016年12月本院收治的尿膿毒癥患者80例為研究對象。納入標準：患者均因各類原因導致泌尿生殖系統感染，并伴有全身炎癥反應綜合征，性別不限，年齡≥18歲。排除標準：排除發病前有心肝肺腎等重要臟器嚴重病癥、惡性腫瘤、凝血、免疫功能異常等患者。……