通讯作者: 李明, limingjtu@163.com

DOI：10.12201/bmr.202603.00104

Prognostic Value of the Lactate/Albumin Ratio Combined with the APACHE II Score in Patients with Sepsis

• 摘要：目的 探究与分析乳酸/白蛋白比值（lactate/albumin ratio, LAR）联合急性生理与慢性健康状态评价系统 Ⅱ（Acute Physiology and Chronic Health Evaluation II, APACHE II）评分对脓毒症患者预后的评估价值。 方法 纳入2022年7月至2025年7月收治于无锡市中医医院重症医学科的76例脓毒症患者，依据28 d生存结局分为死亡组（30例）与生存组（46例）。通过Spearman秩相关分析评估各危险因素与患者28 d死亡之间的相关性；为明确脓毒症预后的独立危险因素，进行多因素Logistic回归分析；并采用受试者工作特征（receiver operating characteristic, ROC）曲线评估各指标对预后的预测价值。 结果 在76例患者中，28 d死亡30例，占比39.5%。Spearman相关性分析显示年龄、冠心病、肝损害、序贯器官衰竭评估（Sequential Organ Failure Assessment, SOFA）评分、APACHE II评分、LAR与脓毒症患者28 d死亡呈现正相关性（P < 0.05），白蛋白则与28 d死亡呈现负相关性（P < 0.001）。多因素Logistic 回归分析表明APACHE II评分与LAR为脓毒症患者28 d死亡的独立危险因素（P < 0.05）。ROC曲线分析中，LAR与APACHE II评分预测28 d死亡的曲线下面积（area under the curv, AUC）分别为0.932和0.737（P < 0.05）；两者联合预测的AUC为0.946（P < 0.05），灵敏度和特异性分别为93.3%和82.6%，LAR和APACHE II评分两者联合预测较两项指标单独预测的价值更高。结论 APACHE II评分与LAR均为脓毒症患者28 d死亡的独立危险因素，且两者联合应用能更有效地评估患者预后。

  关键词： 乳酸/白蛋白比值；APACHE II评分；脓毒症；预后；危险因素; ; ; ; 

   

  Abstract: Objective This study aimed to evaluate the prognostic value of the lactate/albumin ratio (LAR) combined with the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in patients with sepsis. Methods A cohort of 76 sepsis patients admitted to the intensive care unit of Wuxi Traditional Chinese Medicine Hospital from July 2022 to July 2025 were selected. Based on 28-day outcomes, patients were stratified into a non-survival group (n=30) and a survival group (n=46). Spearman correlation analysis was conducted to examine the association between each risk factor and 28-day mortality in patients with sepsis. Independent prognostic factors were identified by multivariate Logistic regression, and the predictive value was assessed via receiver operating characteristic (ROC) curve analysis. Results Among the 76 patients, 30 died within 28 days, accounting for 39.5%. Spearman correlation analysis revealed that age, coronary heart disease, liver injury, Sequential Organ Failure Assessment (SOFA) score, APACHE II score, and LAR were positively correlated with 28-day mortality in patients with sepsis (P < 0.05), while albumin was negatively correlated with 28-day mortality (P < 0.001). Multivariate Logistic regression analysis confirmed the APACHE II score and LAR as independent risk factors for 28-day mortality (P < 0.05). The results of ROC curve analysis showed that the area under the curve (AUC) of LAR and APACHE II score alone in predicting 28-day mortality in patients with sepsis were 0.932 and 0.737, respectively (P < 0.05). The combination of both yielded an AUC of 0.946 (P < 0.05), with a sensitivity of 93.3% and a specificity of 82.6%, demonstrating superior predictive value compared to either indicator alone. Conclusion Both APACHE II score and LAR were identified as independent predictors of 28-day mortality in patients with sepsis, and their combination demonstrated enhanced prognostic value.

  Key words: lactate/albumin ratio; APACHE II score; sepsis; prognosis; risk factors

  提交时间：2026-03-23

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• 序号	提交日期	编号	操作
  1	2026-03-05	10.12201/bmr.202603.00104V1	下载

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