Page 54 - 南京医科大学自然版
P. 54

第44卷第7期
               ·938 ·                          南   京 医 科       大 学      学 报                        2024年7月


                                              表6 ROC曲线分析预测休克指标临界值
                                Table 6 ROC curve analysis of cut⁃off values for predicting shock indicators

                         Variable             AUC     95%CI      P        Cut⁃off    Sensitivity(%)  Specificity(%)
               Respiratory rate              0.595   0.48-0.70  0.059  18 breaths/min    40.5          83.3
               Heart rate                    0.655   0.55-0.75  0.002   88 beats/min     61.9          66.0
               Maximum body temperature      0.655   0.56-0.74  0.002     38.85 ℃        75.6          48.3
                                                                               9
               WBC                           0.586   0.48-0.68  0.086   9.775×10 /L      71.4          45.7
                                                                               9
               NE                            0.600   0.50-0.69  0.046    8.15×10 /L      71.4          45.7
               PT                            0.578   0.47-0.68  0.118     14.75 s        35.7          84.0
               PT internationalized standardized ratio  0.575  0.46-0.68  0.132  1.265   38.1          80.2
               Partial thromboplastin activation time  0.600  0.49-0.70  0.046  33.2 s   42.9          82.7
               Thrombin time                 0.519   0.41-0.62  0.707     18.25 s        26.2          88.3
               GLB                           0.618   0.52-0.71  0.050    27.55 g/L       78.0          44.3
               APACHEⅡ                       0.853   0.79-0.90  <0.001      12           85.1          64.8
               CTP                           0.669   0.57-0.75  <0.001      7            61.7          66.8
                 WBC:white blood cell;NE:neutrophil;PT:prothrombin time;GLB:globulin;APACHEⅡ:acute physiological and chronic health;CTP:Child⁃
              Turcotte⁃Pugh.
                                                表7   死亡组与存活组差异指标比较
                          Table 7 Comparisons of difference indicators between the death group and the survival group  (x ± s)
                             Variable               Death group(n=9)   Survival group(n=38)  t/χ 2      P
                 Respiratory rate(breaths/min)        23.78 ± 9.890       19.13 ± 4.160     -2.08      0.043
                 Heart rate(beats/min)                92.78 ± 17.86       94.45 ± 19.19      0.25      0.808
                 Maximum body temperature(℃)          39.47 ± 1.170       39.17 ± 0.950     -0.72      0.483
                 WBC(×10 /L)                          10.63 ± 4.520       13.68 ± 7.970      1.53      0.140
                         9
                 NE(×10 /L)                            8.91 ± 4.55        11.85 ± 7.840      1.48      0.153
                       9
                 PT(s)                                15.02 ± 3.470       13.92 ± 2.090     -0.91      0.387
                 PT internationalized standardized ratio  1.31 ± 0.31      1.22 ± 0.19      -0.86      0.406
                 Partial thromboplastin activation time(s)  33.85 ± 10.20  31.47 ± 6.750    -0.83      0.524
                 Thrombin time(s)                     17.27 ± 1.160       17.10 ± 1.110     -0.41      0.689
                 GLB(g/L)                             30.17 ± 4.630       30.92 ± 6.600      0.38      0.706
                 APACHEⅡ(score)                       27.89 ± 5.530       15.89 ± 3.650     -6.19     <0.001
                 CTP(score)                            8.44 ± 1.13         6.58 ± 1.01      -4.54      0.001
                 WBC:white blood cell;NE:neutrophil;PT:prothrombin time;GLB:globulin;APACHEⅡ:acute physiological and chronic health;CTP:Child⁃Tur⁃
              cotte⁃Pugh.

                                              表8 脓毒性休克的二元Logistic回归分析
                                        Table 8 Binary logistic regression analysis of septic shock

                         Variable             Partial regression coefficent  OR        95%CI            P
                  Respiratory rate                    0.187              1.206       1.079-1.349      0.001
                  Maximum body temperature            0.399              1.490       1.017-2.185      0.041
                  PT                                  0.196              1.217       1.042-1.421      0.013
                 PT:prothrombin time.
              糖尿病患者多为男性,既往研究证实在对感染和脓                            更大。基于一项855例脓毒症患者的前瞻性研究表
              毒症的反应上,存在明显的性别差异。女性脓毒症                            明,年龄增加与脓毒症的严重程度显著相关(P < 0.05),
              的发病率较低,而且似乎比男性恢复得更快 ,这揭                           65 岁以上患者发生脓毒症休克的可能性更大。原
                                                     [8]
              示了雌激素可能在脓毒症发病过程有重要作用。                             因在于一方面老年人病原体清除效率低,导致免疫
              年龄比较发现,与非休克组相比,休克组患者年龄                            反应时间延长,另一方面免疫衰退时炎症易感性更
   49   50   51   52   53   54   55   56   57   58   59