Abstract:

Objective　To investigate the prognostic value of C-reactive protein (CRP), procalcitonin (PCT), and neutrophil-to-albumin ratio (NAR) in predicting short-term outcomes in patients with septic shock. Methods　A total of 108 patients with septic shock admitted to the Third Hospital of Xi'an and the Third Hospital of Baoji from March 2022 to March 2024 were selected. They were divided into the death group (38 cases) and the survival group (70 cases) based on their 28-day prognosis.The general data, CRP, PCT and NAR levels of the two groups were compared. Logistic analysis was used to identify the influencing factors of 28-day mortality in patients with septic shock and a nomogram was constructed. The receiver operating characteristic curve (ROC) was constructed to analyze the predictive value of CRP, PCT and NAR for 28-day mortality in patients with septic shock.Statistical comparisons were made using the χ² and t tests. Results　There were no statistically significant differences between the death group and the survival group in terms of gender, age, body mass index, history of hypertension, history of diabetes, history of chronic heart failure, infection site, and heart rate (all P > 0.05).There were statistically significant differences in sequential organ failure assessment (SOFA) scores, acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) scores, CRP, PCT, and NAR between the death group and the survival group (all P < 0.05).Logistic regression analysis indicated that SOFA score, APACHE Ⅱ score, CRP, PCT, and NAR were influencing factors for 28-day mortality in patients with septic shock (all P < 0.05).The ROC results indicated that the AUC value of the combined prediction of CRP, PCT and NAR was significantly higher than that of the individual predictions. Conclusion　CRP, PCT and NAR have good predictive value for the short-term prognosis of patients with septic shock.

Key words:

C-reactive protein, Procalcitonin, Neutrophil to albumin ratio, Septic shock, predict

摘要：

目的　探究C反应蛋白（CRP）、降钙素原（PCT）与及中性粒细胞与白蛋白比值（NAR）对脓毒性休克患者短期预后的预测价值。方法　选取2022年3月至2024年3月西安市第三医院和宝鸡市第三医院收治的108例脓毒性休克患者，根据28 d预后情况分为死亡组（38例）与存活组（70例）。比较两组一般资料、CRP、PCT及NAR水平，采用logistic分析脓毒性休克患者28 d死亡的影响因素并构建列线图，构建受试者操作特征曲线（ROC）分析CRP、PCT及NAR对脓毒性休克患者28 d死亡的预测价值。采用χ²和t 检验进行统计比较。结果　死亡组与存活组的性别、年龄、体重指数、高血压史、糖尿病史、慢性心力衰竭史、感染部位、心率比较，差异均无统计学意义（均P>0.05）；死亡组与存活组的序贯器官衰竭（SOFA）评分、急性生理与慢性健康系统Ⅱ（APACHEⅡ）评分、CRP、PCT、NAR比较，差异均有统计学意义（均P <0.05）。logistic回归分析表明，SOFA评分、APACHEⅡ评分、CRP、PCT、NAR是脓毒性休克患者28 d死亡的影响因素（均P <0.05）。ROC结果表明，CRP、PCT及NAR联合预测的AUC值明显高于单独预测。结论　CRP、PCT及NAR对脓毒性休克患者短期预后有着良好的预测价值。

关键词:

C反应蛋白, 降钙素原, 中性粒细胞与白蛋白比值, 脓毒性休克, 预测