Analysis Of The Severity And Prognosis Between NLR、PRP And Patients With Urinary Source Sepsis

Objective:By retrospectively collecting 71 cases of urinary sepsis in Yiyang central hospital,the NLR、PRP was analyzed to analyze whether it was related to the severity and prognosis of urinary sepsis patients.The risk factors and predictive value of severity and prognosis of patients.Methods: A retrospective study was conducted on 71 patients with urogenic sepsis hospitalized in Yiyang Central Hospital from 2018 to2020.The selected cases meet the diagnostic criteria of sepsis Sepsis 3.0and urinary tract infection patients(urinary tract obstruction urinary tract infection patients).The patients were divided into urinary sepsis group and urinary sepsis shock group according to the severity of the disease.The patients with urinary sepsis shock group still needed vasoactive drugs to maintain after active fluid resuscitation.The mean arterial pressure≧65 mm Hg and the lactate ≧2 mmol/L.The prognosis was divided into survival group and death group according to 28 day survival rate.Comparison of selected indicators,APACHEⅡ scores 、NLR、PRP、White blood cell(WBC)、 Neutrophils(NE),C-reactive protein(CRP)、Hemoglobin(HB)、Platelets(PLT)、Lactate(LAC)、 Procalcitonin(PCT)、Albumin(ALB)、Prothrombin time(PT)、Activated partial thromboplastin time(APTT)、 Alanine aminotransferase(ALT)and other indicators were different among different groups.Multivariate logistic regression analysis was used to evaluate the risk factors of severity and prognosis of patients with urinary sepsis.The ROC curve and Cox semi-parametric risk model were established to predict the severity and prognosis of the disease.Results:1.In the comparison of two groups of urinary sepsis and sepsis shock,heart rate,APTT、CRP、LAC、NLR、PRP、PT、APACHEⅡ score,NE,P< 0.05 showed statistical differences between two groups,NE was lower in the uroseptic shock group;heart rate and APTT、CRP、LAC、NLR、PRP、PT、APACHEⅡ score,which were higher in the uroseptic shock group;for other selected variables such as WBC、HB、ALT,ALB,etc.,P> 0.05,and the differences between the two groups had no statistical significance.2.Further analysis was analyzed(APTT、CRP、LAC、NLR、PRP、PT、APACHEⅡ score,NE)in patients with urinary sepsis and urinary septic shock.The results showed a PRP、CRP、NLR、APACHEⅡ score,LAC,P< 0.05,of statistical significance.Index NE,P> 0.05,with no statistical significance.3.In predicting the severity of sepsis,NLR area under the ROC curve is 0.81(95% CI:0.699-0.893),The sensitivity is 79.31%,The specificity was 73.81%,best cut-off value is NLR=20.44.The area under the ROC curve of the combined index NLR APACHEⅡ score was0.899(95% CI:0.804-0.958),The specificity was 90.48%,The sensitivity is 82.76%,The area under the ROC curve PRP the NLR APACHEⅡ score is 0.897(95% CI:0.802-0.957),sensitivity 75.86%,specificity 90.48%.4.For heart rate and CRP、LAC、PRP、NLR、PT、APACHEⅡ score,P< 0.05,it indicates that the difference between the two groups was higher than the survival group;for other variables,like 0.05,the P> in the two groups.5.In the death group and survival group,the PRP、CRP、NLR、APACHEⅡ score,Lac,P<0.05,was statistically significant.6.in predicting prognosis,NLR area below the line is 0.671,PRP area under the curve is 0.659,APACHEⅡ area under the scoring curve was 0.814,When APACHEⅡ score =19 is truncated,60% sensitivity,The specificity was 92.86.The area under the curve PRP the combined index NLR APACHEⅡ score and the NLR APACHEⅡ score were 0.832 and0.839 respectively.Conclusion:1.NLR、PRP showed positive correlation with the severity and prognosis of patients with urinary sepsis,which has certain predictive value.High value of NLR in predicting the severity of patients with urinary source sepsis.