红细胞比容和白蛋白差值鉴别急性失血性休克与感染性休克的临床观察

发布时间：2018-08-24 14:48

【摘要】：目的：探讨红细胞比容(Hct)和白蛋白(Alb)差值用于鉴别急性失血性休克与感染性休克的可行性。方法：本研究病例来源分三部份,第一部份(A组)为健康对照组,健康对照组来自昆明医科大学体检中心,2011年10至2012年3月健康体检者共385例,其中男185例,女200例,年龄20-75岁,检测体检者红细胞比容和白蛋白值,并计算其差值。第二部份(B组)为我科诊断为急性失血性休克的患者,时间为2011年11月至2013年02月,共46例,其中男23例,女23例,年龄18-86岁,患者入科后1小时内检测红细胞比容(Hct)和白蛋白(Alb)值,并计算其差值。第三部份(C组)为我科诊断为感染性休克的患者,时间为2011年12月至2012年11月,共74例,男48例,女26例,年龄26-93岁,检测当患者发生感染性休克后检测到的红细胞比容(Hct)和白蛋白(Alb)值。并计算其差值。绘制红细胞比容和蛋白的差值鉴别急性失血性休克与感染性休克的受试者作用特征(Receiver Operator Characteristic ROC)曲线,计算其曲线下面积(AUC)及阈值,确定灵敏度及特异度。结果：三组患者年龄和性别构成比差异无统计学意义(P0.05)；与A组相比,B组Hct-Alb差值无统计学意义(p0.05)；与A组相比,C组Hct-Alb差值升高(p0.05)；与B组比较,C组Hct-Alb的差值升高(p0.05),受试者作用特征(ROC)曲线分析结果：曲线下面积(AUC)为0.918,Hct-Alb差值的阈值为9.15时,灵敏度为90.5%,特异度为87%。结论：Hct-Alb可以作为急性失血性休克与感染性休克的临床鉴别指标之一其差值的阈值为9.15时,灵敏度为90.5%,特异度为87%。
[Abstract]:Objective: to explore the feasibility of differentiating acute hemorrhagic shock from septic shock by using the difference of specific volume of erythrocyte (Hct) and albumin (Alb). Methods: the cases were divided into three parts. The first part (group A) was a healthy control group. The healthy control group was from Kunming Medical University physical examination Center. There were 385 healthy persons from October 2011 to March 2012, including 185 males and 200 females. The RBC specific volume and albumin were measured and the difference was calculated. The second part (group B) was from November 2011 to February 2013 in 46 patients with acute hemorrhagic shock, including 23 males and 23 females aged 18-86 years. RBC specific volume (Hct) and albumin (Alb) were measured within 1 hour after admission and the difference was calculated. The third part (group C) was a total of 74 patients (48 males and 26 females aged 26-93 years) diagnosed as septic shock in our department from December 2011 to November 2012. RBC specific volume (Hct) and albumin (Alb) were measured after septic shock. The difference is calculated. The specific volume of erythrocyte and the difference between protein and specific volume of erythrocyte were drawn to distinguish the action characteristic (Receiver Operator Characteristic ROC) curve between acute hemorrhagic shock and septic shock. The area (AUC) and threshold value under the curve were calculated and the sensitivity and specificity were determined. Results: there was no significant difference in age and sex composition ratio among the three groups (P0.05), the difference of Hct-Alb between group A and group B was not statistically significant (p0.05), the difference of Hct-Alb between group C and group A was higher than that of group A (p0.05). Compared with group B, the difference of Hct-Alb in group C was higher than that in group B (p0.05). The results of (ROC) curve analysis showed that the threshold value of area under curve (AUC) was 0.918 Hct-Alb difference value was 9.15, the sensitivity was 90.5 and the specificity was 87g. Conclusion as one of the clinical differential markers of acute hemorrhagic shock and septic shock, the threshold value of the differential value is 9.15, the sensitivity is 90.5%, and the specificity is 87.1% Hct-Alb can be used as one of the clinical differential markers of acute hemorrhagic shock and septic shock.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R459.7

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