脓毒症患者血清游离钙水平测定及与预后的关系  

Measurment of serum ionized calcium levels and its correlation with prognosis in sepsis patients

作　　者：李玉芝[1] 李汝勇[1] 张春亮[1] 

机构地区：[1]潍坊市益都中心医院,山东青州262500

出　　处：《山东医药》2010年第23期23-25,共3页Shandong Medical Journal

基　　金：潍坊市卫生局立项课题资助项目(2009-107)

摘　　要：目的观察脓毒症患者血清游离钙水平变化及在预后判定中的价值。方法以同期收治的60例脓毒症患者为研究对象,均于入院24 h内进行急性生理和慢性健康评分(APACHEⅡ评分),并测定血清总钙、白蛋白(Alb)水平,计算血清游离钙水平;比较低钙血症者和血钙正常者APACHEⅡ评分及病死率;对存活者与死亡者年龄、性别、血清总钙、游离钙、Alb水平及APACHEⅡ评分进行比较,将有统计学差异的指标纳入Logistic回归分析模型,分析影响病死率的危险因素。结果60例脓毒症患者低钙血症发生率为78.3%,其中低钙血症者APACHEⅡ评分及病死率均明显高于血钙正常者(P均<0.05);血清游离钙水平与APACHEⅡ评分呈显著负相关,两者均为影响脓毒症患者病死率的危险因素。结论脓毒症患者低钙血症发生率较高;血清游离钙水平与其预后相关,可为临床发现高危患者提供依据。Objective To observe the changes of serum ionized calcium levels in septic patients and its value in prognosis assessment. Methods Sixty patients with sepsis were selected as study object,the standard of acute physiology and chronic health evaluation （APACHE II score） were evaluated within 24 hours after hospitalization,the content of total calcium, albumin （Alb） were determined , and the ionized calcium levels were calculated;the APACHE ]] score and mortality of hypocalcemia cases and normal calcemia ones were compared;the age, sex, serum total calcium, ionized calcium, albumin and APACHE II score between the survival and the dead ones were compared, factors with significant statistics difference were evaluated using Logistic regression analysis, then the risk factors that affected the mortality were analyzed. Results The incidence of hypocalcemia in 60 patients with sepsis was 78.3% ,the APACHE II score and mortality in patients with hypocalcemia were significantly higher than those in the normal calcium ones （ both P 〈 0.05 ） ;serum ionized calcium level and APACHE II score showed significant negative correlation, both were the risk factors that affected the mortality of patients with sepsis. Conclusions Incidence of hypocaleemia in patients with sepsis is higher; serum ionized calcium level is correlated with the prognosis, and is helpful for finding high risk patients.

关 键 词：脓毒症 血清游离钙 预后 

分 类 号：R442.8[医药卫生—诊断学]