Page 87 - 北京京煤集团总医院第十一届·2023学术年会论文集

北京京煤集团总医院 第十一届·2023 学术年会论文集

血浆纤溶酶原激活剂抑制物-1 联合 C 反应蛋白/白蛋白比值

对老年脓毒症患者 28 天预后的预测价值

张雅静，韩雪（北京京煤集团总医院，102300）

【摘要】目的：本研究旨在探讨纤溶酶原激活剂抑制物-1（PAI-1）及 C 反应蛋白/白蛋白比
值 （ CAR）对老年脓毒症患者 28 天预后的预测价值。方法：选择于我院住院治疗的 90 例老

年脓毒症患者和同期在我院体检的健康对照者 30 名作为研究对象。记录老年脓毒症患者的
白细胞计数、血小板计数和淋巴细胞计数，计算序贯器官衰竭评分（SOFA）和急性生理学

与慢性健康状况评分ⅡAPACHEⅡ）。 根据患者的 28 d 生存结局，分为生存组和死亡组。检测
患者和健康对照者的血浆 PAI-1、CAR。结果：老年脓毒症患者的血浆 PAI-1 和 CAR 均显著

高于健康对照者，差异有统计学意义（P＜0.05）。 患者血浆 PAI-1、CAR 与 SOFA 评分、
APACHEⅡ评分分别呈显著正相关关系（P＜0.05）。 28 天内，老年脓毒症患者中死亡 31 人

（34.44%），存活 59 人（65.56%），生存组的淋巴细胞计数显著高于死亡组，SOFA 评分、
血浆 PAI-1、CAR 显著低于死亡组，差异有统计学意义（P＜0.05）。多因素 Logistic 回归分

析，结果表明血浆 PAI-1 和 CAR 水平是影响老年脓毒症患者 28 天预后的独立危险因素（P

＜0.05）。 ROC 曲线分析结果显示，血浆 PAI-1、CAR 及两者联合预测老年脓毒症患者 28d
内死亡的 AUC 分别为 0.752（95%置信区间：0.642~0.862，P＜0.001）， 0.842（95%置信区

间：0.745~0.939，P＜0.001）和 0.887（95%置信区间：0.796~0.977，P＜0.001）。 结论：老
年脓毒症患者的血浆 PAI-1、CAR 显著升高，且两者联合对患者 28 天预后具有较好的临床

预测价值。
【关键词】老年患者；脓毒症；纤溶酶原激活剂抑制物-1；C 反应蛋白/白蛋白比值；预后

Prognostic value of plasma plasminogen activator inhibitor-1 and C-reactive
protein/albumin ratio in 28-day prognosis of elderly patients with sepsis
[Abstract] Objective: This study was to investigate the predictive value of plasminogen activator

inhibitor-1 (PAI-1) and C-reactive protein/albumin ratio (CAR) in 28-day prognosis of elderly
patients with sepsis. Methods: 90 elderly patients with sepsis who were hospitalized in our hospital
and 30 healthy controls who were examined in our hospital during the same period were selected as
the study objects. White blood cell count, platelet count and lymphocyte count were recorded in

elderly patients with sepsis, and Sequential organ failure score (SOFA) and Acute Physiology and
Chronic health status score (APACHEⅡ) were calculated. According to the 28-day survival outcome,
the patients were divided into survival group and death group. Plasma PAI-1 and CAR were detected
in patients and healthy controls. Results: The plasma PAI-1 and CAR levels of elderly patients with

sepsis were significantly higher than those of healthy controls, with statistical significance (P < 0.05).
There were significant positive correlation between PAI-1, CAR and SOFA scores and APACHEⅡ
scores in plasma (P < 0.05). Within 28 days, 31 patients died (34.44%) and 59 survived (65.56%).
The lymphocyte count in the survival group was significantly higher than that in the death group,

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