SOFA评分联合超声对脓毒症合并AKI患者的预后价值分析

本文主要探究SOFA评分联合超声对脓毒症合并急性肾损伤(AKI)患者的预后价值。选取2017年1月~2019年1月本院脓毒症合并AKI患者50例作为观察组,并分为AKI 1、2、3期,将同期入院的50例脓毒症患者作为对照组,两组患者均采用SOFA评分联合超声进行预后评估。结果发现,观察组PDU评分低于对照组(P<0.05),RI值、SOFA评分高于对照组(P<0.05);不同分期的3组间的PDU评分、SOFA评分不同,随着AKI分期的增加,PDU评分降低、SOFA评分增加(P<0.05),但3组间的RI值并无不同(P>0.05);50例脓毒症合并AKI患者发生院内死亡率为44.00%。经单因素分析发现,年龄、机械通气时间、ICU住院时间、AKI分期、脓毒症休克、SOFA评分、PDU评分为影响患者预后不佳的因素(P<0.05);AKI3期、发生脓毒性休克、SOFA评分、PDU评分是脓毒症合并AKI患者预后不佳的独立因素(P<0.05),ROC曲线下面积(AUC)越大,对预后的预测效能越好,当AUC>70.00%时具有临床价值。两者联合显著高于单独应用SOFA评分(AUC=74.28%)或PDU评分(P<0.001)。上述结果说明,脓毒症合并AKI患者采用SOFA评分联合超声用于评估患者的预后,优于单独采用SOFA评分或超声,两者联合的预测价值更大。

Prognostic Value of SOFA Score Combined with Ultrasound in Sepsis Patients with AKI

This article mainly explores the prognostic value of SOFA score combined with ultrasound in patients with sepsis and acute kidney injury(AKI).Fifty patients with sepsis and AKI in our hospital from January 2017 to January 2019 were selected as the observation group and divided into AKI stages 1,2 and 3.The 50 patients with sepsis admitted in the same period were used as the control group.All patients were evaluated by SOFA score and ultrasound.The results showed that the PDU score of the observation group was lower than that of the control group(P<0.05);the RI value and SOFA score were higher than that of the control group(P<0.05).The PDU scores and SOFA scores were different among the three group at different stages.With the increase of AKI stage,the decrease of PDU score and the increase of SOFA score(P<0.05),but the RI value was not different between the three groups(P>0.05);the in-hospital mortality rate of 50 patients with sepsis and AKI was 44.00%.Univariate analysis found that age,mechanical ventilation time,ICU length of stay,AKI stage,septic shock,SOFA score,and PDU score were factors affecting the poor prognosis of patients(P<0.05);AKI stage 3,septic shock occurred,SOFA score,and PDU score were independent factors of poor prognosis in patients with sepsis and AKI(P<0.05).The larger the area under the ROC curve(AUC),the better the predictive power for prognosis.When AUC>70.00%,it has Clinical Value.The combination of the two is significantly higher than the SOFA score(AUC=74.28%)or PDU score(P<0.001).The above results show that patients with sepsis and AKI who use SOFA scores and ultrasound for assessing the prognosis of patients are better than using SOFA scores or ultrasound alone,and the combined predictive value is greater.