Clinical significance analysis of the ratio of C-reactive protein to albumin for predicting acute respiratory distress syndrome in patients with septic shock

Chen Mu-dan; Chen Jian-liang; Wang Jin-zhu; Yang Xiang-hong; Sun Ren-hua; Li Qian

doi:10.3969/j.issn.1002-1949.2018.02.015

Abstract：Objective To discuss the clinical significance of the ratio (CRP/ALB) of C -reactive protein(CRP) to albumin(ALB) for predicting acute respiratory distress syndrome(ARDS) in patients with septic shock. Methods 141 cases with septic shock admitted at department of intensive care unit (ICU) of Zhejiang Provincial People′s Hospital from January 2015 to June 2016 were selected as investigation individuals and divided into the ARDS group and control group. To compare the levels of CRP,ALB and CRP/ALB at time of admission to ICU and the acute physiology and chronic health evaluationⅡ (APACHEⅡ score),sequential organ failure assessment score(SOFA score),lactic acid (Lac) and oxygenation index(OI) at 7th day after admission to ICU of the two groups. To analyze the correlation between the CRP/ALB at time of admission to ICU and the APACHEⅡ score,SOFA score, Lac and OI at 7th day after admission to ICU and draw the receiver-operating characteristic curve(ROC curve) of CRP/ALB for predicting ARDS and find the best cut-off score. Results Of the 141 cases with septic shock, the incidence rate of ARDS was 32. 62% (46/141). There were no statistical significances about levels of CRP and ALB at time of admission to ICU(all P>0.05),while the CRP/ALB(3.04 ± 0.35 vs. 2.39 ± 0.29,t=4.625)of the ARDS group was significantly higher than that of the control group,the difference was statistically significant (P<0.05).At 7th day after admission to ICU the APACHEⅡ score (25.24 ± 5.84 vs. 17.65 ± 4.26, t=4.563), SOFA score (4.25 ± 1.36 vs. 2.03 ± 0.95,t=3.685) and Lac(3.04 ± 0.35 vs. 2.39 ± 0.29, t=4.625)of the ARDS group were significantly higher than those of the control group, while the OI(243.15 ± 36.52 vs. 305.62 ± 39.45,t= -3.752)was obviously lower than that of the control group,differences were all statistically significant (all P<0.05).Correlation analysis showed that the CRP/ALB at time of admission to ICU was positively correlated with the APACHEⅡ score,SOFA score and level of Lac while negatively correlated with OI of at 7th day after admission to ICU(r values were respectively 0.653,0.603,0.596 and -0.795, all P <0.05). Conclusion The CRP/ALB has a high clinical value for predicting ARDS in patients with septic shock. It can help to evaluate the illness state and is worth popularizing in clinical application.