The relationship between ALT/ALP ratio,PLR and hepatic injury in elderly patients with septic shock
- VernacularTitle:ALT/ALP比值、PLR与老年脓毒症休克患者并发肝损伤的关系
- Author:
Hong YU
1
;
Chaodong YANG
;
Dan LIU
Author Information
- Keywords: shock,sepsis; elderly; prognosis; alanine aminotransferase; alkaline phosphatase; liver injury; platelet/lymphocyte ratio
- From: Tianjin Medical Journal 2024;52(11):1211-1215
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the prognostic value of alanine aminotransferase(ALT)/alkaline phosphatase(ALP)ratio,platelet(PLT)count/lymphocyte(LYM)ratio(PLR)in elderly patients with septic shock complicated with liver injury.Methods The clinical data of 116 patients with septic shock complicated with liver injury were retrospectively analyzed.According to the degree of liver injury,patients were divided into the mild group(39 cases),the moderate group(47 cases)and the severe group(30 cases).According to the survival of patients 28 days after admission,patients were divided into the death group(69 cases)and the survival group(47 cases).Acute physiological score,chronic healthⅡ(APACHE Ⅱ)score and sequential organ failure(SOFA)score were collected.PLT and LYM in peripheral blood were detected,and PLR was calculated.ALT and ALP were measured and ALT/ALP ratio was calculated.White blood cell count,blood lactic acid,C-reactive protein and other laboratory indicators were detected.Multivariate Logistic regression was used to analyze prognostic factors of patients with septic shock complicated with liver injury.The predictive values of ALT/ALP ratio and PLR on the prognosis of patients with septic shock complicated with liver injury were analyzed by receiver operating characteristic(ROC)curve.Results Serum ALT and ALP levels,ALT/ALP ratio,PLT and PLR were increased successively in the mild group,the moderate group and the severe group,while LYM was decreased successively in the three groups(P＜0.05).The age,APACHE Ⅱ score,SOFA score,PLR,ALT/ALP ratio and blood lactic acid level were higher in the death group than those in the survival group(P＜0.05).There was no significant difference in liver injury degree between the two groups(P＜0.05).Multivariate Logistic regression analysis showed that high SOFA score,high PLR,high ALT/ALP ratio and moderate to severe liver injury were risk factors for death in patients with septic shock complicated with liver injury.ROC curve analysis showed that the combined ALT/ALP ratio and PLR prediction efficiency[area under the curve 0.915(95%CI:0.849-0.959),sensitivity and specificity 94.20%and 89.36%,respectively]was superior to single prediction(P＜0.05).Conclusion Increased ALT/ALP ratio and PLR are associated with aggravation of liver injury and poor prognosis in patients with septic shock.ALT/ALP ratio and PLR can be used as prognostic markers.
