血清前白蛋白和白蛋白/球蛋白比值对慢性肾衰竭患者的预后价值

目的探讨慢性肾衰竭(CRF)患者的血清前白蛋白(PA)及白蛋白/球蛋白(A/G)比值变化及其预后价值。 方法选取2018年1月至2020年1月于我院接受诊疗的150例CRF患者作为研究对象(研究组),并以150例健康体检者作为对照(健康组)。随访2年后根据患者预后情况分为存活组和死亡组。ELISA检测血清PA水平及A/G比值,Logistic回归分析影响CRF患者预后的危险因素,使用受试者操作特征(ROC)曲线分析血清PA水平和A/G比值对CRF患者预后的预测价值。 结果健康组的血清PA水平和A/G比值显著高于研究组(P<0.05),PA水平与A/G比值呈现正相关(r＝0.772,P<0.001)。随访结果发现150例CRF患者存活118例(78.67%),死亡32例(21.33%)。存活组的血清PA水平和A/G比值显著高于死亡组(P<0.05)。Logistic回归分析显示,血清PA水平、A/G比值降低是影响CRF患者预后的危险因素(P<0.05)。ROC曲线分析显示,血清PA水平、A/G比值的曲线下面积(AUC)分别为0.711、0.697,二者联合的AUC为0.892,显著高于PA、A/G单独的AUC面积(均P<0.001)。 结论CRF患者的血清PA水平与A/G比值显著降低,并与患者预后相关联,二者联合检测可增强对CRF患者的预后价值。

Prognostic value of serum prealbumin and albumin/globulin ratio in patients with chronic renal failure

ObjectiveTo investigate the changes of serum prealbumin (PA) and albumin/globulin ratio (A/G) and their prognostic value in patients with chronic renal failure (CRF). MethodsA total of 150 patients with CRF who were treated in our hospital from January 2018 to January 2020 were selected as the study subjects (study group), and 150 healthy people undergoing physical examination were selected as the control (healthy group). After 2 years of follow-up, the patients were divided into survival group and death group according to their prognosis outcomes. The levels of serum PA and A/G were detected by ELISA. The risk factors affecting the prognosis of patients with CRF were analyzed by logistic regression model, and the predictive value of serum PA and A/G levels on the prognosis of patients with CRF was analyzed using the receiver operating characteristic (ROC) curve. ResultsThe level of serum PA and A/G ratio in the healthy group were significantly higher than those in the study group (P<0.05), and the level of PA and A/G ratio were positively correlated (r=0.772, P<0.001). The follow-up outcomes showed that 118 (78.67%) of the 150 CRF patients survived and 32 (21.33%) died. The serum PA level and A/G ratio in the survival group were significantly higher than those of the death group (P<0.05). Logistic regression analysis showed that the decrease of serum PA level and A/G ratio were risk factors affecting the prognosis of CRF patients (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum PA level and A/G ratio were 0.711 and 0.697 respectively, while the AUC of the combination of the two was 0.892 which was significantly higher than the AUC area of PA and A/G alone (both P<0.001). ConclusionThe leve of serum PA and A/G ratio in the patients with CRF were significantly decreased, and were closely related to the prognosis of the patients. The combined detection of serum PA and A/G ratio may enhance the prognostic value in the CRF patients.