發(fā)布時(shí)間：2018-08-24 14:48

【摘要】：目的：探討紅細(xì)胞比容(Hct)和白蛋白(Alb)差值用于鑒別急性失血性休克與感染性休克的可行性。 方法：本研究病例來源分三部份,第一部份(A組)為健康對照組,健康對照組來自昆明醫(yī)科大學(xué)體檢中心,2011年10至2012年3月健康體檢者共385例,其中男185例,女200例,年齡20-75歲,檢測體檢者紅細(xì)胞比容和白蛋白值,并計(jì)算其差值。第二部份(B組)為我科診斷為急性失血性休克的患者,時(shí)間為2011年11月至2013年02月,共46例,其中男23例,女23例,年齡18-86歲,患者入科后1小時(shí)內(nèi)檢測紅細(xì)胞比容(Hct)和白蛋白(Alb)值,并計(jì)算其差值。第三部份(C組)為我科診斷為感染性休克的患者,時(shí)間為2011年12月至2012年11月,共74例,男48例,女26例,年齡26-93歲,檢測當(dāng)患者發(fā)生感染性休克后檢測到的紅細(xì)胞比容(Hct)和白蛋白(Alb)值。并計(jì)算其差值。繪制紅細(xì)胞比容和蛋白的差值鑒別急性失血性休克與感染性休克的受試者作用特征(Receiver Operator Characteristic ROC)曲線,計(jì)算其曲線下面積(AUC)及閾值,確定靈敏度及特異度。 結(jié)果：三組患者年齡和性別構(gòu)成比差異無統(tǒng)計(jì)學(xué)意義(P0.05)；與A組相比,B組Hct-Alb差值無統(tǒng)計(jì)學(xué)意義(p0.05)；與A組相比,C組Hct-Alb差值升高(p0.05)；與B組比較,C組Hct-Alb的差值升高(p0.05),受試者作用特征(ROC)曲線分析結(jié)果：曲線下面積(AUC)為0.918,Hct-Alb差值的閾值為9.15時(shí),靈敏度為90.5%,特異度為87%。 結(jié)論：Hct-Alb可以作為急性失血性休克與感染性休克的臨床鑒別指標(biāo)之一其差值的閾值為9.15時(shí),靈敏度為90.5%,特異度為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.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R459.7

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