心脑血管病防治2025，Vol.25Issue(2)：11-15,5.DOI:10.3969/j.issn.1009-816x.2025.02.003
乳酸/白蛋白比值与心跳骤停合并或并发急性肾损伤患者预后的相关性
Correlation between lactate to albumin ratio and prognosis in patients with cardiac arrest complicated or comorbid with acute kidney injury
摘要
Abstract
Objective To investigate the correlation between lactate to albumin ratio(LAR)and the prognosis of patients with cardiac arrest(CA)complicated or comorbid with acute kidney injury(AKI).Methods A retrospective analysis was conducted using the clinical data of 505 patients with CA complicated or comorbid with AKI from the Medical Information Mart for Intensive Care-IV(v2.0)database from 2008 to 2019.Based on the 28-day clinical outcomes of all-cause mortality,all of the enrolled patients were divided into the survival group(235 cases)and the death group(270 cases),and the baseline data were compared.The patients were further categorized into four groups(LAR<0.66 group,LAR 0.66-1.11 group,LAR>1.11-2.10 group,and LAR>2.10 group)according to the quartiles of LAR levels.The differences in 28-day cumulative survival rates among the four groups were compared using Kaplan-Meier survival curves.Cox proportional hazards regression model was used to analyze whether LAR at the time of admission to the intensive care unit(ICU)was an independent risk factor for 28-day all-cause mortality in patients with CA complicated or comorbid with AKI.The ROC curve was used to assess the performance of LAR,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,and the combined indicator in predicting prognosis of patients.Results The LAR level was higher in the death group than in the survival group(χ2=-4.821,P<0.05).Survival curve analysis indicated that patients in the LAR>2.10 group had the lowest 28-day cumulative survival rate,the difference among the four groups was statistically significant(χ2=31.720,P<0.01).Multivariate Cox regression analysis showed that LAR>2.10 was an independent risk factor for 28-day all-cause mortality in patients with CA complicated or comorbid with AKI(HR=1.612,P<0.05).The ROC curves demonstrated that the AUCs for predicting 28-day all-cause mortality in patients with CA complicated or comorbid with AKI were 0.624 for LAR,0.603 for the APACHE Ⅱ score,and 0.637 for the combined indicators,with sensitivities of 0.581,0.763,and 0.707,and specificities of 0.651,0.404,and 0.506,respectively.The combined prediction efficacy was superior to that of APACHE Ⅱ score(Z=2.544,P<0.01).Conclusion High LAR(>2.10)at ICU admission is an independent risk factor for short-term all-cause mortality in patients with CA complicated or comorbid with AKI.LAR in combination with the APACHE Ⅱ score has certain predictive value for the short-term prognosis of such patients.关键词
乳酸与白蛋白比值/心跳骤停/急性肾损伤/预后Key words
Lactate to albumin ratio/Cardiac arrest/Acute kidney injury/Prognosis引用本文复制引用
翁文倩,陆建红,姬晓伟..乳酸/白蛋白比值与心跳骤停合并或并发急性肾损伤患者预后的相关性[J].心脑血管病防治,2025,25(2):11-15,5.基金项目
浙江省自然科学基金(LGD20H150001) （LGD20H150001）
