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目的:探讨影响成年急性创伤性休克患者的预后因素。方法:采用回顾性队列研究分析2013年7月至2021年9月聊城市第二人民医院收住ICU的122例成年急性创伤性休克患者的临床资料，其中男90例，女32例；年龄18~83岁［（49.8±16.9）岁］。损伤严重度评分（ISS）为14~50分［（28.6±6.3）分］。根据患者预后情况分为预后良好组（48例）和预后不良组（74例）。比较两组性别、年龄及急诊入院时的白细胞计数、中性粒细胞计数、淋巴细胞计数、血小板计数、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、D-二聚体、乳酸、ISS和休克指数（SI）。采用单因素逐步回归分析及多因素Logistic回归分析确定影响预后的因素。采用受试者工作特征（ROC）曲线分析对影响预后的因素进行预测价值的评价，计算曲线下面积（AUC）、灵敏度、特异度和最佳预测临界值，并对预后有影响的因素进行分层分析。结果:两组性别、血小板计数、D-二聚体、ISS和SI差异无统计学意义（n P均>0.05）；预后不良组年龄、淋巴细胞计数和乳酸水平高于预后良好组，而白细胞计数、中性粒细胞计数、NLR和PLR低于预后良好组（n P均<0.01）。单因素逐步回归分析结果显示，年龄和NLR与急性创伤性休克患者预后有一定相关性（n P均0.05）。多因素Logistic回归分析结果表明，年龄（n OR=0.96，95%n CI 0.93~0.98）和NLR（n OR=1.19，95%n CI 1.10~1.29）是急性创伤性休克患者预后的影响因素。ROC曲线分析结果显示，年龄的AUC为0.32（95%n CI 0.22~0.41，n P<0.01），最佳预测临界值为48.5岁（敏感度68.9%，特异度64.6%）；NLR的AUC为0.79（95%n CI 0.71~0.90，n P<0.01），最佳预测临界值为6.51（敏感度77.1%，特异度71.6%）。分层分析结果显示, 随着年龄的增长，预后不良组所占比例逐渐升高（n P<0.01）；随着NLR水平的升高，预后不良组所占比例明显下降（n P0.05). The age, lymphocyte count and lactate level in poor prognosis group were higher than those in good prognosis group, while the leukocyte count, neutrophil count, NLR and PLR in poor prognosis group were lower than those in good prognosis group (alln P<0.01). Univariate stepwise regression analysis showed that age and NLR were related to the prognosis of patients with acute traumatic shock (alln P0.05). Multivariate Logistic regression analysis showed that age (n OR=0.96, 95%n CI 0.93-0.98) and NLR (n OR=1.19, 95%n CI 1.10-1.29) were the affecting factors for prognosis of patients with acute traumatic shock. ROC analysis showed the AUC of age for 0.32 (95%n CI 0.22-0.41) together with the optimal cut-off value predicting prognosis for 48.5 years (sensitivity 68.9%, specificity 64.6%), the AUC of NLR for 0.79 (95%n CI 0.71-0.90) together with the optimal cut-off value predicting prognosis for 6.51 (sensitivity 77.1%, specificity 71.6%). Stratified analysis showed that the proportion of patients in poor prognosis group was increased gradually with the increase of age (n P<0.01), while that was decreased significantly with the increase of NLR level (n P<0.01).n Conclusions:Age and level of NLR on emergency admission can predict the prognosis of adult patients with acute traumatic shock, with the best cut-off value of 48.5 years and 0.79. Moreover, advanced age and lower level of NLR indicate much poorer prognosis.