RLR联合SAA/hs-CRP比值对脓毒症患者预后的评估价值OA
The Evaluation Value of the RLR Combined with the SAA/hs-CRP Ratio in Assessing the Prognosis of Patients with Sepsis
目的 探讨红细胞体积分布宽度/淋巴细胞比值(RLR)联合血清淀粉样蛋白A/超敏C反应蛋白(SAA/hs-CRP)比值对脓毒症患者预后的评估价值.方法 选取2024年4月至2025年6月沧州市人民医院收治的134例脓毒症患者,根据患者入院后28 d预后情况分为生存组(104例)和死亡组(30例).比较两组入院时一般资料及RLR、SAA/hs-CRP水平.采用受试者工作特征(ROC)曲线评估RLR、SAA/hs-CRP及二者联合对脓毒症患者预后的预测价值,采用多因素Logistic逐步回归分析脓毒症患者预后的影响因素.结果 死亡组患者RLR、SAA/hs-CRP、序贯器官衰竭评估(SOFA)评分、国家早期预警评分、急性生理与慢性健康评估系统Ⅱ(APACHE Ⅱ)评分及丙氨酸氨基转移酶、天冬氨酸氨基转移酶、血乳酸水平均高于生存组(P<0.05).ROC曲线评估显示,RLR、SAA/hs-CRP评估脓毒症患者预后的曲线下面积(AUC)分别为0.847(95%CI:0.802～0.897)、0.752(95%CI:0.702～0.797),二者联合的AUC为0.907(95%CI:0.857～0.952),高于单一指标(Z=12.958、9.472,均P<0.05).多因素Logistic逐步回归分析结果显示,APACHE Ⅱ评分(OR=1.988,95%CI:1.126～3.509)、SOFA评分(OR=2.040,95%CI:1.162～3.581)、RLR(OR=3.136,95%CI:1.808～5.440)、SAA/hs-CRP(OR=3.651,95%CI:2.138～6.234)是脓毒症患者预后的影响因素(P<0.05).结论 入院时RLR、SAA/hs-CRP比值升高与脓毒症患者死亡风险增加相关,二者联合应用可更有效地对患者进行危险分层与预后评估.
Objective To investigate the value of the red blood cell distribution width to lymphocyte count ratio(RLR)combined with the serum amyloid A to high-sensitivity C-reactive protein ratio(SAA/hs-CRP)in assessing the prognosis of patients with sepsis.Methods A total of 134 patients with sepsis admitted to Cangzhou People's Hospital from April 2024 to June 2025 were enrolled.According to the 28-day prognosis after admission,patients were divided into a survival group(104 cases)and a death group(30 cases).General data,RLR,and SAA/hs-CRP at admission were compared between the two groups.The prognostic value of RLR,SAA/hs-CRP,and their combination for patients with sepsis was analyzed using the receiver operating characteristic(ROC)curve.Multivariate logistic stepwise regression was used to analyze the influencing factors for the prognosis of patients with sepsis.Results The RLR,SAA/hs-CRP,sequential organ failure assessment(SOFA)score,national early warning score,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,as well as levels of alanine aminotransferase,aspartate aminotransferase,and blood lactic acid in the death group were significantly higher than those in the survival group(P<0.05).ROC curve analysis showed that the AUC of RLR and SAA/hs-CRP for evaluating the prognosis of septic patients were 0.847(95%CI:0.802-0.897)and 0.752(95%CI:0.702-0.797),respectively.The AUC of their combination was 0.907(95%CI:0.857-0.952),which was higher than that of either single indicator(Z=12.958,9.472,both P<0.05).Multivariate logistic stepwise regression analysis showed that APACHEⅡ score(OR=1.988,95%CI:1.126-3.509),SOFA score(OR=2.040,95%CI:1.162-3.581),RLR(OR=3.136,95%CI:1.808-5.440),and SAA/hs-CRP(OR=3.651,95%CI:2.138-6.234)were independent influencing factors for the prognosis of patients with sepsis(P<0.05).Conclusion Elevated RLR and SAA/hs-CRP ratio at admission are associated with an increased risk of death in patients with sepsis.The combination of these two indicators can more effectively stratify the risk and evaluate the prognosis of these patients.
张琪;卢清龙;戚桂艳;赵天翔;迟智超
沧州市人民医院重症医学科,河北 沧州 061000沧州市人民医院重症医学科,河北 沧州 061000沧州市人民医院重症医学科,河北 沧州 061000沧州市人民医院重症医学科,河北 沧州 061000沧州市人民医院重症医学科,河北 沧州 061000
脓毒症红细胞体积分布宽度/淋巴细胞计数比值血清淀粉样蛋白A/超敏C反应蛋白比值预后
sepsisred blood cell distribution width to lymphocyte count ratioserum amyloid A to high-sensitivity C-reactive protein ratioprognosis
《转化医学杂志》 2026 (4)
626-630,5
河北省医学科学研究课题计划项目(20251488)
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