Early Diagnostic Value Of PRA In Sepsis Complicated With Acute Respiratory Distress Syndrome

ObjectivesTo investigate the predictive value of Procalcitonin(PCT)to albumin(ALB)ratio(PAR)in the early diagnosis of sepsis complicated with acute respiratory distress syndrome(ARDS),and to explore the risk factors of sepsis complicated with ARDS,so as to put forward a new idea for clinical prevention and treatment of sepsis complicated with ARDS.MethodsAccording to the inclusion and exclusion criteria,461 patients with pathogens detected in blood culture of the First Affiliated Hospital of Dali University from January 2013 to November 2020 were selected as the research objects.The patients were divided into sepsis group(281 cases)and non sepsis group(180 cases)according to the score of SOFA ≥ 2.To investigate the differences in general conditions(gender,age,height,weight,BMI and the type of pathogenic bacteria cultured)and related laboratory indicators(TBIL,ALT,AST,ALB,UREA,CREA,UA,WBC,CRP,PCT,CRP/ALB ratio and PAR)between the two groups.According to oxygenation index ≤ 300 mm Hg,patients in sepsis group were divided into sepsis complicated with ARDS group(131 cases)and sepsis without ARDS group(150cases).Binary logistic regression analysis was used to analyze the risk factors of ARDS in sepsis patients according to whether the patients in sepsis group were complicated with ARDS;Receiver operating characteristic curve(ROC)was used to analyze the predictive value of PCT,ALB,CRP,WBC,CRP/ALB ratio and PAR in the early diagnosis of sepsis complicated with ARDS.Resuits1.Gender(male),age,TBIL,ALT,AST,ALB,UREA,CREA,UA,PCT,CRP,WBC,CRP/ALB ratio and PAR in sepsis group were significantly higher than those in non-sepsis group.The difference was statistically significant(P < 0.05).2.The gender(male),smoking,drinking,diabetes,SOFA score,APACHEⅡ score,PCT,ALB,Pa O2,Pa CO2,HCO3-,LAC,FPG,CRP/ALB ratio and PAR of patients with ARDS complicated with sepsis were significantly higher than those of patients without ARDS complicated with sepsis.The difference was statistically significant(P < 0.05).3.The analysis of binary logistics regression equation showed that PAR,SOFA score and APACHEⅡ score were the risk factors for sepsis complicated with ARDS,while low CRP level was the protective factor for sepsis complicated with ARDS.4.PAR is an important predictor for the diagnosis of sepsis complicated with ARDS.In the early stage,it can preliminarily distinguish patients with sepsis complicated with ARDS from those without sepsis complicated with ARDS.The area under the ROC curve was: 0.763,95%CI: 0.71-0.82,sensitivity: 71%,specificity: 73%,Youden index: 0.43.Conclusions1.PAR is an independent risk factor for sepsis complicated with ARDS.2.PAR has a higher predictive value for early diagnosis of sepsis complicated with ARDS than PCT,ALB,CRP and CRP/ALB ratio.3.PAR can be used as a marker for early diagnosis of ARDS in sepsis patients.