危重病患者尿微量白蛋白水平变化与APACHE Ⅱ评分的关系  

The relationship of microalbuminuria levels and acute physiology and chronic health evaluationⅡscores in critically ill patients

作　　者：王丽芳[1] 李永军[1] 张晋霞[1] 霍书花[2] 

机构地区：[1]河北医科大学第二医院检验科,石家庄050000 [2]河北医科大学第二医院急诊科石家庄,050000

出　　处：《感染．炎症．修复》2005年第2期82-84,共3页Infection Inflammation Repair

基　　金：河北省2004年医学科学研究重点课题计划(编号04209)

摘　　要：目的：探讨危重病患者尿标本中微量白蛋白(MA)水平的变化与APACHEⅡ评分及疾病严重程度和预后的关系。方法：采用速率散射比浊法检测尿MA,全自动生化分析仪检测尿肌酐(Cr),APACHEⅡ评分采用相应软件。结果：正常对照组尿MA/Cr水平为1．8+0．4mg/mmolCr,危重病患者组进入ICU 6h尿MA/Cr水平为11．7士9．7mg/mmolCr,两者比较有显著性差异(P＜0．01)。尿MA/Cr比率与APACHEⅡ评分有良好的相关性。死亡组与存活组患者MA/Cr比率分别为24．5±15．1mg/mmolCr和8．3±2．4mg/mmolCr,两者比较差异显著(P＜0．01)。结论：早期检测尿微量白蛋白与APACHEⅡ评分均能不同程度地反映危重病患者病情及预后,两者同步测定有助于更准确地判断患者的病情及预后和决定IC收治标准、治疗范围和强度,在临床上推广应用有实用参考价值。Objective:To explore the relationship of the prognosis and the severity of disease as evaluated by a- cute physiology and chronic health evaluationⅡ(APACHEⅡ)scores and microalbuminuria levels in critically ill patients.Method:Serial spot urine albumin-creatinine ratios were measured 6 hours after admission to the ICU in 52 critically ill patients of both genders between ages of 18 and 72 years.Albuminuria was estimated by automated imunoturbidimetric method and urine creatinine by automatic biochemistry analysis.APACHEⅡscores were as- sessed for the patients in the first 24 hours in ICU.Results:Urinary microalbumin:creatinine(MA/Cr)ratios measured at 6 hours after admission to the ICU were markedly higher than that in controls (11.7±9.7 mg/mmol- Cr vs.1.8±0.4 mg/mmolCr,P＜0.01).APACHEⅡscores were positively correlated with MA/Cr ratios(r= 0.7115,P＜0.01).Conclusions:Microalbuminuria within 6 hours of admission to the intensive care unit as well as APACHEⅡscores assessed after 24 hours of admission could be used to reflect the seriousness of the patients and the prognosis.The accuracy and specificity in evaluating the prognosis seem to be enhanced when these two pa- rameters are combined.

关 键 词：尿微量白蛋白 APACHEⅡ评分 危重病 

分 类 号：R45[医药卫生—治疗学]