脓毒症患者血清淀粉酶升高的临床意义  

Clinical significance of the elevation of serum amylase in sepsis patients

作　　者：明自强[1] 俞林明[1] 王黎卫[1] 吕银祥[1] 

机构地区：[1]浙江省新昌县人民医院ICU,新昌312500

出　　处：《临床医学》2008年第9期37-38,共2页Clinical Medicine

摘　　要：目的探讨脓毒症患者血清淀粉酶升高的临床意义及其与预后的关系。方法80例ICU脓毒症(APACHEⅡ评分>30分)患者,根据血清淀粉酶水平分为血清淀粉酶升高组(Ⅰ组)和正常组(Ⅱ组),比较两组血白细胞总数、低血压发生率、心律失常发生率、机械通气使用率、住院时间及病死率的变化。结果80例脓毒症患者中,18例(22.5%)血清淀粉酶升高,胰腺损伤(血清淀粉酶≥400 U/L)发生率为11.3%。血清淀粉酶升高组低血压发生率、心律失常发生率、机械通气使用率、ICU住院时间、病死率明显高于血清淀粉酶正常组。血清淀粉酶水平愈高,预后愈差。血清淀粉酶≥400 U/L,病死率明显增高(P<0.01)。结论对脓毒症患者应注意血清淀粉酶的变化,血清淀粉酶可能是反映病情变化、判定预后的一个重要指标。Objective To investigate the clinical significance of elevation of serum amylase in sepsis patients and the relationship with the prognosis. Methods The data of 80 sepsis patients （ APACHE Ⅱ score 〉 30 ） in intensive care unit （ICU） were retrospectively analyzed, and all the patients were divided into 2 groups ： hyperamylasemia and normal serum amylase. Total white blood cells, hypotension, mechanical ventilation, the time in ICU and mortality of two groups were compared. Results Eighteen patients serum amylase elevated （22.5%） , incidence of pancreas injury（ serum amylase ≥400 U/L, Somogyi） was 11. 3%. The rate of mechanical ventilation, hypotension, the time of staying in the ICU, and mortality were all obviously higher in the hyperamylasemia patients than in normal group. The higher serum amylase was , the worse prognosis was. The mortality increased obviously ,when serum amylase ≥400 U/L（Somogyi） , P 〈0.01. Conclusion Variation of the serum amylase may be an important index to reflect the states and assess the prognosis of the illness.

关 键 词：血清淀粉酶 脓毒症 临床分析 治疗方法 

分 类 号：R459.7[医药卫生—急诊医学]