专蛋白校正的离子间隙与危急性休克患者60天全因死亡率之间的关联
Yan-Ke Zou1,2, Shi-Li Zhong1,3, Li-Huan Gong1
1Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
European journal of medical research
|December 24, 2025
概括
蛋白校正的离子间隙 (ACAG) 能够有效预测重症监护病房休克患者60天的死亡率. 较高的ACAG水平表明死亡风险增加,并且将ACAG与评分系统结合起来可以改善预测.
科学领域:
- 关键护理医学 关键护理医学
- 临床化学 临床化学
- 预测生物标志物 预测生物标志物
背景情况:
- 蛋白校正的离子间隙 (ACAG) 反映了酸状态和代谢平衡.
- ACAG显示在预测休克患者的预后方面有潜力.
研究的目的:
- 评估ACAG对ICU休克患者60天全因死亡率的预测值.
主要方法:
- 使用了MIMIC-IV数据库 (v3.1),包括10,144名休克患者.
- 使用ROC曲线来评估ACAG的预测性能并确定风险值 (19.25).
- 构建了考克斯的比例危险模型,具有时间依赖的共变量,包括ACAG,SAPSII和LAC.
主要成果:
- 在预测60天死亡率方面,ACAG的AUC值为0.68,超过了离子间隙 (AG).
- 高ACAG水平 (≥19.25) 与显著较低的60天生存概率相关 (P < 0.001).
- 高ACAG组显示死亡风险增加了72.5% (HR=1.725). 将ACAG与评分系统相结合,提高了预测准确度.
结论:
- ACAG是一种快速,低成本,早期预测休克患者死亡率的方法.
- 在ICU休克患者中,ACAG水平升高与60天死亡率有显著的联系.
- 将ACAG与现有的评分系统集成,可以提高对休克患者结果的预测能力.
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