| NPS联合FAR对脓毒症患者预后的预测价值 |
| 投稿时间：2024-11-18 修订日期：2024-12-09 点此下载全文 |
| 引用本文：刘茂明,杨国辉.NPS联合FAR对脓毒症患者预后的预测价值[J].医学研究杂志,2025,54(5):174-179, 202 |
| DOI：
10.11969/j.issn.1673-548X.2025.05.030 |
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| 基金项目:贵州医科大学附属医院国家自然科学(NSFC)地区基金培育项目(gyfynsfc-2021-54) |
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| 中文摘要:目的 探讨那不勒斯预后评分(Naples Prognostic Score,NPS)联合纤维蛋白原-白蛋白比(fbrinogen-albumin ratio,FAR)对脓毒症患者预后的预测价值。方法 回顾性分析2019年1月~2024年1月贵州医科大学附属医院内科重症监护病房(medical intensive care unit,MICU)收治的脓毒症患者临床资料,根据观察28天临床结局将脓毒症患者分为存活组和死亡组。比较两组间NPS、FAR及NPS与FAR联合评分之间的差异；通过受试者工作特征(receiver operating characteristic,ROC)曲线和决策曲线分析(decision curve analysis,DCA)评估NPS、FAR及NPS+FAR对预后的预测性能。结果 本研究共纳入245例脓毒症患者,根据28天临床观察,存活组140例,死亡组105例。两组间在纤维蛋白原(fibrinogen,Fg)、白蛋白(albumin, Alb)、总胆固醇(total cholesterol,TC)、FAR、NPS、急性生理学和慢性健康评分Ⅱ(acute physiology and chronic health evaluation Ⅱ,APACHE Ⅱ)和序贯器官衰竭评分(sequential prgan failure assessment,SOFA)比较,差异有统计学意义(P＜0.05)。多因素Logistic回归分析显示,SOFA、APACHE Ⅱ、FAR、NPS为脓毒症患者预后不良的独立危险因素(P＜0.05)。NPS(ROC曲线下面积为0.738)、FAR(ROC曲线下面积为0.755)分别对脓毒症患者28天预后有较好的预测价值。然而,NPS+FAR(ROC曲线下面积为0.812)联合评分比NPS、FAR单独使用能够更好的预测脓毒症患者28天的临床结局。此外,包括NPS+FAR、SOFA、APACHE Ⅱ的三重指数(ROC曲线下面积为0.930)显著增加了脓毒症患者28天病死率的预测价值。结论 NPS、FAR及NPS+FAR联合对脓毒症28天不良结局均有较好的预测价值。 |
| 中文关键词:那不勒斯预后评分 纤维蛋白原-白蛋白比 脓毒症 脓毒性休克 |
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| Predictive Value of Naples Prognostic Score Combined with Fibrinogen Albumin Ratio for the Prognosis of Sepsis Patients. |
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| Abstract:Objective To explore the predictive value of Naples Prognostic Score (NPS) combined with Fibrinogen Albumin Ratio (FAR) for the prognosis of sepsis patients. Methods A retrospective analysis was conducted on the clinical data of sepsis patients admitted to the Medical Intensive Care Unit (MICU) of Guizhou Medical University Affiliated Hospital between January 2019 and January 2024. Based on 28-day clinical outcomes, these patients were divided into a survival group and a death group. Differences in NPS, FAR, and the combined scores of NPS and FAR were compared between the two groups. The predictive performance of NPS, FAR, and NPS+FAR for prognosis was evaluated using Receiver Operating Characteristic (ROC) curves and Decision Curve Analysis (DCA). Results This study enrolled a total of 245sepsis patients. Following a 28-day clinical observation, there were 140 patients in the survival group and 105 in the death group. Significant differences (P<0.05) were observed in fibrinogen (Fg), albumin, FAR, NPS, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), and Sequential Organ Failure Assessment (SOFA) scores between the two groups. Multivariate Logistic regression analysis indicated that SOFA, APACHE Ⅱ, FAR and NPS were independent risk factors for poor prognosis in sepsis patients (P<0.05). NPS (with an area under the ROC curve of 0.738) and FAR (with an area under the ROC curve of 0.755) exhibited good predictive value for the 28-day prognosis of sepsis patients. However, the combined score of NPS+FAR (with an area under the ROC curve of 0.812) proved to be a more accurate predictor of 28-day prognosis in sepsis patients compared to NPS or FAR alone. Additionally, the triple index, which includes NPS + FAR, SOFA, and APACHE Ⅱ (with an area under the ROC curve of 0.930), significantly enhanced the predictive value for 28-day mortality in sepsis patients. Conclusion NPS, FAR, and the combination of NPS and FAR have good predictive value for adverse outcomes in sepsis at 28days. |
| keywords:Naples prognostic score Fibrinogen-to-albumin-ratio Sepsis Septic shock |
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