血清D-二聚体、尿素氮与肌酐比值联合C反应蛋白与白蛋白比值对重症肺炎患者院内死亡的评估价值

摘要 目的：探讨血清D-二聚体（D-D）、尿素氮与肌酐比值（UCR）联合C反应蛋白与白蛋白比值（CAR）对重症肺炎（SP）患者院内死亡的评估价值。方法：选取2019年6月～2022年6月我院收治的101例SP患者，根据是否发生院内死亡分为死亡组和存活组。检测血清D-D和计算UCR、CAR。分析SP患者院内死亡的影响因素，受试者工作特征（ROC）曲线分析血清D-D、UCR、CAR对SP患者院内死亡的评估价值。结果：101例SP患者院内死亡率40.59％（41/101）。死亡组血清D-D、UCR、CAR高于存活组（P均＜0.05）。多因素Logistic回归分析显示，年龄增加、肺外并发症≥2个和D-D、UCR、CAR升高为SP患者院内死亡的独立危险因素（P均＜0.05）。ROC曲线分析显示，血清D-D、UCR、CAR单独与联合评估SP患者院内死亡的曲线下面积分别为0.781、0.798、0.793、0.929，血清D-D、UCR联合CAR评估SP患者院内死亡的AUC大于各指标单独评估。结论：血清D-D、UCR、CAR升高为SP患者院内死亡的独立危险因素，D-D、UCR联合CAR对SP患者院内死亡的评估价值较高。

Value of Serum D-Dimer and Urea Nitrogen to Creatinine Ratio Combined with C-Reactive Protein to Albumin Ratio in the Assessment of In-Hospital Mortality in Patients with Severe Pneumonia

ABSTRACT Objective: To investigate the value of serum D-dimer (D-D) and urea nitrogen to creatinine ratio (UCR) combined with C-reactive protein to albumin ratio (CAR) in the assessment of in-hospital mortality in patients with severe pneumonia (SP). Methods: 101 patients with SP who were admitted to our hospital from June 2019 to June 2022 were selected, and they were divided into death group and survival group according to whether in-hospital death occurred. Serum D-D was detected and UCR and CAR were calculated. The influencing factors of in-hospital death in patients with SP were analyzed. The value of serum D-D, UCR and CAR in the evaluation of in-hospital death in patients with SP was analyzed by receiver operating characteristic(ROC) curve. Results: In-hospital mortality in 101 patients with SP was 40.59%(41/101). Serum D-D, UCR and CAR in the death group were higher than those in the survival group (all P<0.05). Multivariate Logistic regression analysis showed that increased age, extrapulmonary complications greater than or equal to 2 and increased D-D, UCR and CAR were independent risk factors for in-hospital mortality in patients with SP(all P<0.05). ROC curve analysis showed that the areas under curve of serum D-D, UCR and CAR alone and in combination to evaluate in-hospital death of patients with SP were 0.781, 0.798, 0.793 and 0.929, respectively. The AUC of serum D-D, UCR combined with CAR to evaluate in-hospital death of patients with SP was greater than that of each index alone. Conclusion: The increased serum D-D, UCR and CAR are independent risk factors for in-hospital death in patients with SP, and the combination of D-D and UCR with CAR has a high evaluation value for in-hospital death in patients with SP.