动脉血乳酸/血清白蛋白比值预测老年重症社区获得性肺炎患者预后的回顾性研究

张立涛; 马佳倩; 齐惠军; 许宁; 李建国

doi:10.13201/j.issn.1009-5918.2021.05.001

动脉血乳酸/血清白蛋白比值预测老年重症社区获得性肺炎患者预后的回顾性研究

- 河北省人民医院急诊科(石家庄, 050071)

详细信息

通讯作者: 李建国,E-mail:litle2000@sohu.com

中图分类号: R563

收稿日期: 2021-01-27

A retrospective study of arterial lactic acid/serum albumin ratio in predicting the prognosis of elderly patients with severe community-acquired pneumonia

- Department of Emergency, Hebei General Hospital, Shijiazhuang, 050071, China

More Information

Corresponding author: LI Jianguo, E-mail: litle2000@sohu.com

Received Date: 27 January 2021

摘要

摘要: 目的:探讨动脉血乳酸/血清白蛋白比值(Lac/Alb)对老年重症社区获得性肺炎(CAP)患者院内死亡率的预测价值。方法:纳入2019年1月-2020年10月期间于河北省人民医院急诊科就诊的老年重症CAP患者61例,收集患者一般资料及动脉血乳酸和白蛋白水平,并计算Lac/Alb值。根据患者是否院内死亡将患者分为生存组(n=27)和死亡组(n=34),采用受试者工作特征(ROC)曲线评估Lac/Alb对老年重症CAP患者院内死亡率的预测价值。结果:两组患者年龄、性别比较差异无统计学意义(均P>0.05),同时两组患者PCT、CRP、中性粒细胞计数、淋巴细胞计数、中性粒细胞/淋巴细胞比值(NLR)、白蛋白以及血肌酐水平差异无统计学意义(均P>0.05)。生存组患者PaO₂/FiO₂明显高于死亡组[178.40(141.71,255.00) mmHg vs.106.29(89.11,164.75) mmHg,P<0.01]。生存组患者乳酸及Lac/Alb水平明显低于死亡组[(2.41±1.26) mmol/L vs.(3.24±1.51) mmol/L,(0.88±0.41)vs.(1.29±0.67),均P<0.01]。PaO₂/FiO₂和患者院内生存呈正相关(r=0.503,P<0.01),乳酸和Lac/Alb与患者院内生存呈负相关(分别为r=-0.306,r=-0.347,均P<0.05)。Lac/Alb预测老年重症CAP患者预后的AUC=0.701(95%CI:0.570~0.812),以1.48为截断值其预测的敏感度和特异度分别为96.30%和35.29%。结论:Lac/Alb对老年重症CAP患者的预后具有较好的预测价值。
- 乳酸/白蛋白 /
- 重症社区获得性肺炎 /
- 预后
Abstract: Objective: To explore the predictive value of arterial lactic acid/serum albumin ratio(Lac/Alb) in hospital mortality of elderly patients with severe community-acquired pneumonia(CAP).Methods: Sixty-one elderly patients with severe CAP treated in the emergency department of Hebei General Hospital from January 2019 to October 2020 were enrolled. The general data and arterial blood lactic acid and albumin levels were collected, and the Lac/Alb values were calculated. According to whether the patients died in hospital, the patients were divided into survival group(n= 27) and death group(n= 34). The ROC curve was used to evaluate the predictive value of Lac/Alb on in-hospital mortality in elderly patients with severe CAP.Results: There was no significant difference in age and sex between the two groups(both P>0.05), and there was no significant difference in PCT, CRP, neutrophil count, lymphocyte count, neutrophil/lymphocyte ratio(NLR), albumin and serum creatinine between the two groups(all P>0.05). The PaO₂/FiO₂ in the survival group was significantly higher than that in the death group[178.40(141.71-255.00) mmHg vs. 106.29(89.11-164.75) mmHg, P<0.01]. The levels of lactic acid and Lac/Alb in the survival group were significantly lower than those in the death group[(2.41±1.26) mmol/L vs.(3.24±1.51) mmol/L,(0.88±0.41) vs.(1.29±0.67), both P<0.01]. PaO₂/FiO₂ was positively correlated with in-hospital survival(r=0.503, P<0.01), while lactic acid and Lac/Alb were negatively correlated with in-hospital survival(r=-0.306, r=-0.347, both P<0.05). The AUC of Lac/Alb in predicted the prognosis of severe CAP was 0.701(95%CI:0.570-0.812), with a cutoff value of 1.48, the sensitivity and specificity were 96.30% and 35.29% respectively.Conclusion: Lac/Alb can predict the prognosis of elderly patients with severe CAP.
- lactate/albumin /
- severecommunity-acquiredpneumonia /
- prognosis

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