外周血MHR联合RPR对脓毒症患者预后的预测价值

Prognostic value of peripheral blood MHR combined with RPR in patients with sepsis

摘要:

目的 探究外周血单核细胞与高密度脂蛋白胆固醇比值（MHR）联合红细胞分布宽度与血小板计数比值（RPR）对脓毒症患者预后的预测价值。方法 回顾性分析2024年6月-2025年3月南京医科大学附属淮安第一医院收治的102例脓毒症患者，患者均行单核细胞计数、血小板计数、高密度脂蛋白胆固醇、红细胞分布宽度检测。根据预后分为生存组（72例）和死亡组（30例）。收集相关资料，采用多因素逐步Logistic回归分析患者预后因素，绘制受试者工作特征（ROC）曲线分析MHR、RPR水平对患者预后的预测价值。结果 死亡组急性生理学和慢性健康状况评价Ⅱ（APACHE Ⅱ）评分、MHR、RPR、序贯器官衰竭评估（SOFA）评分均高于生存组（P <0.05），动脉血氧分压、血红蛋白、白蛋白水平均低于存活组（P <0.05）。多因素逐步Logistic回归分析结果显示：APACHE Ⅱ评分高［O^R=5.623（95% CI：1.560，20.261）］、白蛋白水平低［O^R=0.287（95% CI：0.152，0.538）］、SOFA评分高［O^R=3.151（95% CI：1.478，6.714）］、MHR水平高［O^R=4.043（95% CI：2.322，7.040）］、RPR水平高［O^R=8.144（95% CI：3.345，19.829）］均为患者预后死亡的危险因素（P <0.05）。ROC曲线分析显示，MHR、RPR及其联合预测预后的敏感性分别为75.0%、78.1%、84.4%，特异性分别为76.9%、73.1%、84.6%，曲线下面积分别为0.811、0.809、0.901。结论 外周血MHR、RPR水平是脓毒症患者预后的独立危险因素，且二者联合检测对患者预后预测价值更高。

Abstract:

Objective To explore the prognostic value of peripheral blood monocyte to high-density lipoprotein cholesterol ratio (MHR) combined with red blood cell distribution width to platelet count ratio (RPR) in patients with sepsis.Methods A total of 102 patients with sepsis admitted to our hospital from June 2024 to March 2025 were retrospectively selected. Monocyte count, platelet count, high density lipoprotein cholesterol, and red blood cell distribution width were detected in all patients. According to the prognosis, the patients were divided into the survival group and the death group. Clinical data of the two groups of patients were collected, and the influencing factors of patient prognosis were analyzed by multivariable logistic regression. The predictive value of MHR and RPR on patient prognosis was analyzed using the receiver operating characteristic (ROC) curve.Results The Acute Physiology and Chronic Health Evaluation II (APACHE Ⅱ) score, MHR, RPR and Sequential Organ Failure Assessment (SOFA) score in the death group were higher than those in the survival group (P < 0.05), while the arterial partial pressure of oxygen, hemoglobin level and albumin level were all lower in the death group than those in the survival group (P < 0.05). The multivariable logistic regression analysis showed that high APACHE Ⅱ scores [O^R = 5.623 (95% CI: 1.560, 20.261) ], low albumin levels [O^R = 0.287 (95% CI: 0.152, 0.538) ], high SOFA scores [O^R = 3.151 (95% CI: 1.478, 6.714) ], high MHR [O^R = 4.043 (95% CI: 2.322, 7.040) ], and high RPR [O^R = 8.144 (95% CI: 3.345, 19.829) ] were all risk factors for the death of patients (P < 0.05). ROC curve analysis demonstrated that the sensitivities of MHR, RPR and their combination for predicting the prognosis of patients were 75.0%, 78.1%, and 84.4%, with the specificities being 76.9%, 73.1%, and 84.6%, and the areas under the curves (AUCs) being 0.811, 0.809, and 0.901, respectively (P < 0.05).Conclusion High peripheral blood MHR and RPR are independent risk factors for the prognosis of patients with sepsis, and the combination of the two is more valuable in predicting the patient prognosis.