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乳酸脱氢酶与白蛋白比值作为新生儿败血症28天死亡率的独立因素

Lactate dehydrogenase to albumin ratio as an independent factor for 28-day mortality of neonatal sepsis.

作者信息

Xia Xiaohong, Qiu Shengfeng, Cheng Xiangjun, Xie Mengxiao, Zhou Jun

机构信息

Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, Jiangsu, China.

出版信息

Sci Rep. 2025 Apr 30;15(1):15158. doi: 10.1038/s41598-025-89108-8.

Abstract

Neonatal sepsis significantly contributes to infant mortality rates. The absence of predictive markers has hindered timely clinical intervention, leading to elevated mortality. This study aimed to assess the prognostic relevance of the lactate dehydrogenase (LDH)-to-albumin ratio (LAR) in neonatal sepsis. A retrospective examination was conducted on a cohort of 130 neonates diagnosed with sepsis. Admission laboratory data were gathered. The optimal threshold for LAR was established using receiver operating characteristic curve analysis. Both univariate and multivariate analyses were performed to gauge the predictive efficacy of LAR. A statistical disparity in LAR was noted between survivors and non-survivors (p < 0.001). Multivariate analysis confirmed that LAR serves as an independent risk determinant for neonatal sepsis (Hazard ratio [HR] 11.236, 95% Confidence interval [CI] 3.311-38.462, p < 0.001). ROC analysis indicated that the area under the curve for LAR was 0.806 across the entire cohort, 0.842 for early-onset sepsis, and 0.737 for late-onset sepsis. Moreover, with a cutoff value set at 23.72, LAR exhibited a prediction specificity of 88.2% and sensitivity of 70.0%. Our research indicates that elevated admission LAR is a negative prognostic indicator in neonatal sepsis, suggesting its potential as a valuable biomarker in clinical settings.

摘要

新生儿败血症是导致婴儿死亡率的重要因素。缺乏预测标志物阻碍了及时的临床干预,导致死亡率升高。本研究旨在评估乳酸脱氢酶(LDH)与白蛋白比值(LAR)在新生儿败血症中的预后相关性。对130例诊断为败血症的新生儿队列进行了回顾性研究。收集入院时的实验室数据。采用受试者工作特征曲线分析确定LAR的最佳阈值。进行单因素和多因素分析以评估LAR的预测效力。在幸存者和非幸存者之间观察到LAR存在统计学差异(p<0.001)。多因素分析证实,LAR是新生儿败血症的独立风险决定因素(风险比[HR]11.236,95%置信区间[CI]3.311-38.462,p<0.001)。ROC分析表明,整个队列中LAR的曲线下面积为0.806,早发型败血症为0.842,晚发型败血症为0.737。此外,当临界值设定为23.72时,LAR的预测特异性为88.2%,敏感性为70.0%。我们的研究表明,入院时LAR升高是新生儿败血症的不良预后指标,表明其在临床环境中作为有价值生物标志物的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61e6/12043797/7b23d09385a4/41598_2025_89108_Fig1_HTML.jpg

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