【摘要】 目的 探究序贯器官衰竭估计(SOFA)评分联合血清白细胞介素-6(IL-6)、C反应蛋白(CRP)及乳酸对重症肺炎28d预后的预测效能。方法 选取本院2020年到2023年98例重症肺炎患者，根据其28d后的死亡情况，分为生存组(n=60),死亡组(n=38),收集患者的一般资料，根据中文版的简化SOFA评分计算分数；在入院的次日空腹抽取5 ml静脉血和2 ml外周动脉血，采用酶联免疫吸附法检测血清IL-6、CRP水平检测采用透射比浊法进行测定。血乳酸水平用比色法检测；采用Logistic回归分析重症肺炎28d死亡的危险因素；采用ROC曲线分析SOFA评分联合血清IL-6、CRP、乳酸检测水平对重症肺炎28d预后的预测效能。结果 两组患者的性别、年龄、基础疾病个数和体重质量情况均无统计学差异(P>0.05);死亡组的SOFA评分分数以及血清IL-6、CRP、乳酸检测水平均高于生存组，且差异具有统计学意义(P<0.05);多因素Logistic回归结果显示，SOFA评分分数以及IL-6、CRP、乳酸检测水平都是重症肺炎患者28d死亡的危险因素(P<0.05);由ROC曲线分析可得，SOFA评分以及血清IL-6、CRP、乳酸检测水平预测重症肺炎28d预后的AUC分别为：0.816,0.719。0.782,0.799;灵敏度分别为：65.8%,57.9%,78.9%,63.2%;特异度分别为：88.3%,80.0%,81.7%,88.3%;四个指标联合预测的AUC为0.917,灵敏度为80.9%,特异度为90.3%。结论 SOFA评分分数以及IL-6、CRP、乳酸检测水平越高的重症肺炎患者，其28d死亡的风险越高；SOFA评分联合血清IL-6、CRP、乳酸检测水平对于重症肺炎28d预后具有较高的预测效能。更多还原

【Abstract】 Objective To explore the predictive efficacy of Sequential Organ Failure Assessment(SOFA) score combined with serum interleukin-6(IL-6),C-reactive protein(CRP) and lactate on 28-day prognosis of severe pneumonia.Methods Ninety-eight patients with severe pneumonia in our hospital from 2020 to 2023 were selected, and classified into survival group(n=60) and death group(n=38) according to the 28-day mortality status.The clinical data of participants were collected, and patients were assessed using SOFA.Milliliters of fasting venous blood(5 ml) and peripheral arterial blood(2 ml) were subjected to complete IL-6,CRP and lactate tests using transmission turbidimetry and colorimetry.Then Logistic regression analysis was performed to screen the risk factors for 28-day mortality of severe pneumonia, and receiver operating characteristic(ROC) curve was plotted to evaluate the predictive efficacy of SOFA score combined with serum IL-6,CRP and lactate on the 28-day prognosis of severe pneumonia.Results No statistical difference was reported between two groups in gender, age, number of comorbid underlying diseases, body weight and body mass index(P>0.05).SOFA score, serum IL-6,CRP,and lactate levels in death group were higher than those in survival group, with statistical difference(all P<0.05).ROC curve denoted showed that the area under the curve(AUC) of SOFA score, serum IL-6,CRP,and lactate for predicting the 28-day prognosis of severe pneumonia was 0.816,0.719,0.782 and 0.799,with sensitivity of 65.8%,57.9%,78.9% and 63.2%,and specificity of 88.3%,80.0%,81.7%,and 88.3%,respectively.The AUC,sensitivity and specificity of combined test of SOFA score, serum IL-6,CRP,and lactate for predicting the 28-day prognosis of severe pneumonia were 0.917,80.9% and 90.3%.Conclusion Severe pneumonia patients with higher SOFA score, serum IL-6,CRP,and lactate suffer a higher risk of 28-day mortality rate, furthermore, the combined test of SOFA score, serum IL-6,CRP,and lactate is of great predictive value for 28-day mortality in patients.更多还原