血清Alb、Mb及MEWS、Waterlow评分对重症监护病房患者压力性损伤的预测价值

摘要 目的：探讨血清白蛋白（Alb）、肌红蛋白（Mb）及改良早期预警评分（MEWS）、Waterlow评分对重症监护病房（ICU）患者压力性损伤（PI）的预测价值。方法：选取2021年6月～2022年12月在新疆维吾尔自治区人民医院ICU住院的患者120例，根据是否发生PI分为PI组43例和非PI组77例。ICU患者PI的影响因素采用多因素Logistic回归分析，血清Alb、Mb及MEWS、Waterlow评分对ICU患者PI的预测价值采用受试者工作特征（ROC）曲线分析。结果：PI组年龄大于非PI组，机械通气比例、体温、Mb、MEWS、Waterlow评分高于非PI组，住院时间长于非PI组，Alb低于非PI组（P＜0.05）。住院时间延长和Mb升高、MEWS增加、Waterlow评分增加为ICU患者PI的独立危险因素，Alb升高为其独立保护因素（P＜0.05）。血清Alb、Mb及MEWS、Waterlow评分四项联合预测ICU患者PI的曲线下面积大于各指标预测（P＜0.05）。结论：血清Alb水平降低和Mb、MEWS、Waterlow评分升高与ICU患者PI发生独立相关，血清Alb、Mb及MEWS、Waterlow评分联合对ICU患者PI具有良好预测价值。

Predictive Value of Serum Alb, Mb, MEWS and Waterlow Scores for Pressure Injury in Intensive Care Unit Patients

ABSTRACT Objective: To explore the predictive value of serum albumin (Alb), myoglobin (Mb), modified early warning score (MEWS) and Waterlow score for pressure injury (PI) in intensive care unit (ICU) patients. Methods: 120 patients who were hospitalized in the ICU of the People''s Hospital of Xinjiang Uygur Autonomous Region from June 2021 to December 2022 were selected, patients were divided into PI group (43 cases) and non-PI group (77 cases) according to whether PI occurred. The influencing factors of PI in ICU patients were analyzed by multivariate Logistic regression analysis, the predictive value of serum Alb, Mb, MEWS and Waterlow scores for PI in ICU patients was analyzed by receiver operating characteristic (ROC) curve. Results: The age in PI group was higher than that in non-PI group, the proportion of mechanical ventilation, body temperature, Mb, MEWS and Waterlow scores were higher than those in non-PI group, the length of hospital stay was longer than that in non-PI group, and Alb was lower than that in non-PI group (P<0.05). Prolonged hospitalization time and elevated Mb, increased MEWS, and increased Waterlow score were independent risk factors for PI in ICU patients, and elevated Alb was an independent protective factor (P<0.05). The area under the curve of serum Alb, Mb, MEWS and Waterlow score in predicting PI in ICU patients was greater than that predicted by each index (P<0.05). Conclusion: The decrease of serum Alb level and the increase of Mb, MEWS and Waterlow scores are independently correlate with PI in ICU patients, the combination of serum Alb, Mb, MEWS and Waterlow scores has good predictive value for PI in ICU patients.