血清GGT、AST和血小板比值与ICU脓毒症患者并发急性肝损伤的关系OA

Objective:To explore the relationship between serum γ-glutamyltranspeptidase to platelet ratio(GPR),aspartate aminotransferase to platelet ratio(APRI),and acute liver injury in sepsis patients in the intensive care unit(ICU).Methods:A retrospective single center study was conducted on 550 sepsis patients who stayed in the ICU for more than 24 hours from January 2020 to January 2025.According to the occurrence of acute liver injury within 24 hours of admission to the ICU,patients were divided into an occurrence group(n=84)and a non occurrence group(n=466).The differences in serum GPR,APRI index,and other related data were compared between two groups,Pearson or Spearman correlation analysis was used to investigate the relationship between serum GPR and APRI indices and the indicators that might affect the occurrence of acute liver injury in ICU patients with sepsis.Multivariate Logistic regression analysis was employed to identify the independent risk factors for acute liver injury in ICU patients with sepsis.The receiver operating characteristic(ROC)curve was utilized to assess the predictive value of serum GPR and APRI indices for acute liver injury in ICU patients with sepsis.Results:The sequential organ failure score(SOFA),procalcitonin,total bilirubin,prothrombin time(PT)value,international normalized ratio(INR),GPR,and APRI index in the occurrence group were all higher than those in the non occurrence group,with statistical significant differences(P<0.05).Pearson or Spearman correlation analysis showed that serum GPR procalcitonin,total bilirubin,PT,and INR were positively correlated(r>0,P<0.05),and APRI index was positively correlated with SOFA score,procalcitonin,total bilirubin,and PT(r>0,P<0.05).According to Logistic regression analysis,high SOFA score,high procalcitonin,high total bilirubin,prolonged PT,high INR,high GPR value,and high APRI index were all risk factors for acute liver injury in ICU sepsis patients(P<0.05).The ROC curve showed that the area under the curve(AUC)of serum GPR and APRI indices alone and in combination for predicting acute liver injury in ICU sepsis patients was 0.822,0.825,and 0.909,respectively.The value of combined prediction was relatively high.The ICU stay and total hospitalization time of the occurrence group were longer than those of the non occurrence group,and the mortality rate during hospitalization was lower than that of the non occurrence group(P<0.05).Conclusion:There was a certain correlation between serum GPR and APRI index and acute liver injury in ICU sepsis patients.These two indicators can serve as independent predictive factors for the occurrence of acute liver injury in sepsis patients and have certain predictive value for the occurrence of sepsis complicated with acute liver injury.Early intervention is needed to improve patient prognosis.