Liang Peipei, Wei Zhijian, Xia Junjie, Yu Feng
The First Affiliated Hospital of Anhui Medical University, Department of Emergency Intensive Care Unit, Hefei, China.
The First Affiliated Hospital of Anhui Medical University, Department of General Surgery, Hefei, China.
J Med Biochem. 2024 Nov 16;43(6):927-935. doi: 10.5937/jomb0-50687.
This study investigates the correlation between the difference in hematocrit (HCT) and serum albumin (ALB) levels (HCT-ALB), muscle tissue oxygen saturation (SmtO2), capillary refill time (CRT), and blood lactate (Lac) with the severity of renal function damage and prognosis in patients with septic shock.
Conducted from February 2022 to February 2024, this study included 116 septic shock patients treated at the First Affiliated Hospital of Anhui Medical University. Patients were divided into groups based on whether they developed acute kidney injury: 40 patients were included in the acute kidney injury group, and the remaining 76 were placed in the non-kidney injury group. The levels of HCT-ALB, SmtO2, CRT, and Lac were compared between the groups. Patients were followed up to assess their 28day survival outcomes; 75 surviving patients were placed in the survival group, and 41 deceased patients were in the death group. Differences in clinical data and levels of HCTALB, SmtO2, CRT, and Lac between the two groups were analyzed to explore the relationship of these indicators with patient prognosis.
Levels of HCT-ALB, CRT, and Lac were higher, while SmtO2 was lower in the acute kidney injury group compared to the non-kidney injury group (P<0.05). Similarly, the death group exhibited higher levels of HCTALB, CRT, and Lac and lower SmtO2 levels compared to the survival group (P<0.05). Univariate and multivariate analyses revealed that HCT-ALB, SmtO2, CRT, and Lac significantly impact patient survival outcomes, demonstrating high predictive value for patient mortality with respective AUC values of 0.834, 0.782, 0.903, and 0.918. The combined application of these indicators for predicting patient mortality had an AUC value of 0.985, which is higher than when the indicators were used individually.
HCT-ALB, SmtO2, CRT, and Lac are significantly elevated in patients with acute kidney injury and deceased patients, closely correlating with the severity and prognosis of septic shock. These indicators can serve as essential biomarkers for assessing the condition and prognosis of these patients.
本研究旨在探讨脓毒症休克患者血细胞比容（HCT）与血清白蛋白（ALB）水平差值（HCT-ALB）、肌肉组织氧饱和度（SmtO2）、毛细血管再充盈时间（CRT）和血乳酸（Lac）与肾功能损害严重程度及预后的相关性。
本研究于2022年2月至2024年2月进行，纳入安徽医科大学第一附属医院收治的116例脓毒症休克患者。根据是否发生急性肾损伤将患者分组：急性肾损伤组40例，其余76例纳入非肾损伤组。比较两组患者的HCT-ALB、SmtO2、CRT和Lac水平。对患者进行随访以评估其28天生存结局；75例存活患者纳入存活组，41例死亡患者纳入死亡组。分析两组患者临床资料及HCT-ALB、SmtO2、CRT和Lac水平的差异，以探讨这些指标与患者预后的关系。
与非肾损伤组相比，急性肾损伤组的HCT-ALB、CRT和Lac水平较高，而SmtO2较低（P<0.05）。同样，与存活组相比，死亡组的HCT-ALB、CRT和Lac水平较高，SmtO2水平较低（P<0.05）。单因素和多因素分析显示，HCT-ALB、SmtO2、CRT和Lac对患者生存结局有显著影响，对患者死亡率具有较高的预测价值，各自的AUC值分别为0.834、0.782、0.903和0.918。联合应用这些指标预测患者死亡率的AUC值为0.985，高于单独使用这些指标时。
急性肾损伤患者和死亡患者的HCT-ALB、SmtO2、CRT和Lac显著升高，与脓毒症休克的严重程度和预后密切相关。这些指标可作为评估这些患者病情和预后的重要生物标志物。
