血清尿酸/白蛋白比值与脓毒症患者并发急性肾损伤的相关性及预测价值
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江苏省卫生计生委面上项目(H201618); 江苏省姑苏卫生人才培养项目(GSWS2020010);


Correlation between serum uric acid/albumin ratio and acute kidney in-jury in patients with sepsis and its predictive value
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    摘要:

    目的:探讨血清尿酸(UA)/白蛋白(Alb)比值(sUAR)与脓毒症并发急性肾损伤(AKI)的相关性,评估其预测价值。方法:回顾性分析196例脓毒症患者临床资料,根据是否发生AKI将其分为AKI组(n=95)与非AKI组(n=101)。比较两组患者血清sUAR水平及其他临床指标,使用Logistic回归分析筛选脓毒症相关AKI(SA-AKI)的危险因素,并使用受试者工作特征(ROC)曲线评价相关指标的预测价值。结果:与非AKI组相比,AKI组年龄较大(P<0.05),合并冠心病比例、急性生理学和慢性健康状况II(APACHE II)评分、脓毒症相关器官衰竭(SOFA)评分及降钙素原(PCT)、血肌酐、UA水平、sUAR水平更高(P<0.05),Alb水平更低(P<0.05)。Logistic回归分析得出,年龄较大(OR=1.718)、合并冠心病(OR=1.478)、较高SOFA评分(OR=2.201)和较高sUAR水平(OR=2.487)是SA-AKI的危险因素(P<0.05)。ROC曲线分析得出,sUAR预测SA-AKI发生的曲线下面积(AUC)为0.778,截断值为>8.2μmol/g,敏感度为81.1%,特异度为64.4%;且sUAR联合SOFA评分预测SA-AKI的AUC更高,为0.855。结论:血清sUAR水平升高与SA-AKI密切相关,sUAR对脓毒症患者并发AKI有一定预测价值,联合SOFA评分可提高预测效能。

    Abstract:

    Objective:To investigate the correlation between serum uric acid(UA)/albumin(Alb)ratio(sUAR)and sepsis complicated with acute kidney injury(AKI),and to evaluate its predictive value.Methods:The clinical data of 196 patients with sepsis were retrospectively analyzed.According to the occurrence of AKI,they were divided into AKI group(n=95)and non-AKI group(n=101).The differences of serum sUAR level and other clinical indicators between the two groups were compared.Logistic regression anal-ysis was used to screen the risk factors of sepsis-associated AKI(SA-AKI),and the predictive value of related indicators was evaluated by receiver operating characteristic(ROC)curve.Results:Compared with the non-AKI group,the AKI group was older(P<0.05),the proportion of combined coronary heart disease,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sepsis-related organ failure(SOFA)score,procalcitonin(PCT),serum creatinine,UA level,sUAR level were higher(P<0.05),and the Alb level was lower(P<0.05).Logistic regression analysis showed that older age(OR=1.718),combined coronary heart disease(OR=1.478),higher SOFA score(OR=2.201)and higher sUAR level(OR=2.487)were risk factors for SA-AKI(P<0.05).ROC curve analysis showed that the AUC of sUAR in predicting SA-AKI was 0.778,the cutoff value was>8.2 μmol/g,the sensitivity was 81.1%,and the specificity was 64.4%.The AUC of sUAR combined with SOFA score in predicting SA-AKI was higher,which was 0.855.Conclusion:The increase of serum sUAR level is closely related to SA-AKI.sUAR has a certain predictive value for AKI in pa-tients with sepsis,and combined with SOFA score can improve the predictive efficacy.

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杨玲;郭强;.血清尿酸/白蛋白比值与脓毒症患者并发急性肾损伤的相关性及预测价值[J].川北医学院学报,2025,40(2):191-194.

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  • 在线发布日期: 2025-07-24
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