张剑　潘剑峰　江颖锵

【摘要】 目的：探讨尿脓毒症C反应蛋白/白蛋白比值（CAR）与其病情和短期预后的关系。方法：选取2015年1月-2016年12月本院收治的尿脓毒症患者80例为研究对象。观察治疗前后的CAR、APACHE Ⅱ评分和28 d病死率。比较不同预后的CAR和APACHE Ⅱ评分，分析其CAR与APACHE Ⅱ评分和28 d病死率的关系，并采用ROC曲线分析治疗前后的CAR预测其28 d病死率的价值。结果：与治疗前比较，治疗后的CAR和APACHE Ⅱ评分均降低（P<0.05），患者28 d病死率为8.75%。与存活患者比较，死亡患者治疗前后的CAR和APACHE Ⅱ评分均升高（P<0.05）。Spearman无条件相关分析结果显示，尿脓毒症患者CAR与APACHE Ⅱ评分和28 d病死率均呈正相关（r=0.826、0.853，P<0.05）。ROC曲线分析结果显示，尿脓毒症患者治疗前后的CAR预测其28 d病死率的价值良好，其中以治疗后的CAR预测其28 d病死率的价值最优。结论：尿脓毒症患者CAR较高与其其病情和预后相关，可能作为其病情和预后评估的参考指标。

【关键词】 尿脓毒症； C反应蛋白/白蛋白比值； 病情； 短期预后； 关系

【Abstract】 Objective：To investigate the relationship between C reactive protein/albumin ratio（CAR） and its severity with short-term prognosis in patients with urinary sepsis.Method：80 cases of patients with urinary sepsis in our hospital from January 2015 to December 2016 were selected as the research objects.Before and after treatment CAR，APACHE Ⅱ score and 28 day mortality of were observed.Bbefore and after treatment，the CAR，APACHE Ⅱ score of patients with different prognosis were compared，and the relationship between CAR with APACHE Ⅱ score and 28 day mortality rate were analyzed，the ROC curve was used to analyze the value of CAR before and after treatment.Result：Compared with before treatment，the CAR and APACHE Ⅱ score of after treatment were decreased（P<0.05）.The 28 day mortality rate of the patients was 8.75%.Compared with the surviving patients，the CAR and APACHE Ⅱ scores were higher before and after treatment（P<0.05）.Spearman unconditional correlation analysis results showed that CAR was positively correlated with APACHE Ⅱ score and 28 day mortality in patients with urinary sepsis（r=0.826，0.853；P<0.05） .ROC curve analysis results showed that value of the before and after treatment CAR of patients with urinary sepsis predicting the 28 day mortality was good，in which the value of after treatment CAR predicting the 28 day mortality was better.Conclusion：CAR of patients with urinary sepsis is related to the disease severity and prognosis，which may be used as reference index for the evaluation of disease severity and prognosis of patients with urinary sepsis.

【Key words】 Urinary sepsis； C reactive protein/albumin ratio； Disease； Short term prognosis； Relationship

First-authors address：The Fifth Peoples Hospital of Nanhai District of Foshan，Foshan 528211，China

doi：10.3969/j.issn.1674-4985.2017.25.030

泌尿系統感染为临床常见病症，若无及时有效干预，可导致严重泌尿系统感染寄尿脓毒症的发生，病情凶险且变化快，治疗困难，严重危及患者健康和生命安全[1-3]。因此，其对尿脓毒症病情和预后具有重要意义。尿脓毒症为感染性疾病，而C反应蛋白、白蛋白均与感染密切相关[4-7]。因此CRP、ALB可能与尿脓毒症相关，可能用于其病情变化评估，而C反应蛋白/白蛋白比值（C reactive protein/albumin ratio，CAR）综合了两个因子变化，可能更有利于评估其病情和预后。为此，本研究检测了尿毒症患者的CAR，并分析了其与病情指标和短期预后指标的关系及其对患者短期预后的评估价值，旨在为尿脓毒症的病情和预后评估干预提供指导，现报道如下。endprint

1 资料与方法

1.1 一般资料 选取2015年1月-2016年12月本院收治的尿脓毒症患者80例为研究对象。纳入标准：患者均因各类原因导致泌尿生殖系统感染，并伴有全身炎症反应综合征，性别不限，年龄≥18岁。排除标准：排除发病前有心肝肺肾等重要脏器严重病症、恶性肿瘤、凝血、免疫功能异常等患者。……