实用医学杂志2025，Vol.41Issue(12)：1840-1845,6.DOI:10.3969/j.issn.1006-5725.2025.12.010
血浆纤维蛋白原水平对脓毒性休克患者院内死亡的预测价值
Predictive value of plasma fibrinogen for in-hospital mortality in patients with septic shock
摘要
Abstract
Objective To explore the association between plasma fibrinogen(FBG)levels and the risk of in-hospital mortality among patients with septic shock.Methods The clinical data of 563 patients diagnosed with septic shock in the Intensive Care Unit(ICU)of Shenzhen Second People's Hospital from August 1,2018,to December 31,2020,were collected.Patient demographic information,basic vital signs,and blood routine and biochemical indices upon admission were gathered.Moreover,the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)scores were calculated.Binary logistic regression analysis was conducted to explore the correlation between plasma fibrinogen levels and in-hospital mortality in patients with septic shock.Additionally,a generalized additive model(GAM)and smoothed curve fitting were employed to investigate the nonlinear relationship between plasma fibrinogen and in-hospital mortality.Receiver operating characteristic(ROC)curves were constructed for FBG and APACHEⅡ scores to predict in-hospital mortality in septic shock patients.The area under the curve(AUC)was computed to compare the predictive efficacies of the two.Furthermore,a segmented linear regression model was utilized for quantification.Results Binary logistic regression analysis demonstrated a significant negative correlation between plasma fibrinogen levels and in-hospital mortality among patients with septic shock(P<0.05).GAM modeling and smoothed curve fitting disclosed a nonlinear association between plasma fibrinogen levels and in-hospital mortality,with an inflection point at 5.54 g/L.The segmented linear regression model indicated that,to the left of the inflection point(FBG≤5.54 g/L),for every 1 g/L decrease in plasma fibrinogen,the risk of death increased by 24.5%(OR=0.755,P=0.003).Conversely,to the right of the inflection point(FBG>5.54 g/L),the relationship was not statistically significant(OR=1.049,P=0.685).The findings of the subgroup analyses indicated that the characteristics of the subgroups did not alter the relationship between blood fibrinogen levels and in-hospital mortality.Conclusion There is a nonlinear relationship between FBG levels and in-hospital mortality in patients with septic shock,which has predictive value for evaluating the risk of in-hospital mortality in this patient cohort.关键词
脓毒性休克/血浆纤维蛋白原/院内死亡/非线性关系Key words
septic shock/plasma fibrinogen/in-hospital mortality/non-linear relationship分类
临床医学引用本文复制引用
周力,韩勇,庞婷,雷景恒,曾珊,王静静,周岳杰,李舒雅,邓哲..血浆纤维蛋白原水平对脓毒性休克患者院内死亡的预测价值[J].实用医学杂志,2025,41(12):1840-1845,6.基金项目
深圳市科技计划项目(编号:KCXFZ2023073109410002) （编号:KCXFZ2023073109410002）
深圳市创伤救治临床研究中心项目(编号:LCYSSQ20220823091405012) （编号:LCYSSQ20220823091405012）
