脓毒症导致多器官功能障碍综合征相关危险因素分析  

Risk Factors of Multiple Organ Dysfunction Syndrome Caused by Sepsis

作　　者：周华锋[1] 刘立[1] 裴辉[1] 刘保池[2] 

机构地区：[1]郑州大学第一附属医院急诊科,河南省郑州市450052 [2]复旦大学附属公共卫生临床中心

出　　处：《中国全科医学》2010年第32期3591-3593,共3页Chinese General Practice

摘　　要：目的探讨脓毒症患者发展为多器官功能障碍综合征(MODS)的相关危险因素。方法选取2006年8月—2009年12月收治的196例脓毒症患者,分为脓毒症组153例和MODS组43例,回顾性分析其临床资料,进行单因素分析并行二元变量Logistic逐步回归筛选相关危险因素。结果脓毒症组死亡7例(4.6%),MODS组死亡27例(62.8%),两组比较差异有统计学意义(P<0.05)。共88份标本分离出病原菌,其中G-66例,G+17例,混合感染5例。MODS组患者年龄、急性生理学及慢性健康状况评分系统(APACHEⅡ)评分升高、合并慢性病、血肌酐水平升高、动脉血pH值、平均动脉压、细菌培养阳性、存在电解质紊乱、血糖水平较脓毒症组均明显升高,差异有统计学意义(P<0.05)。Logistic回归分析示APACHEⅡ评分升高、合并慢性病、血肌酐水平升高、细菌培养阳性是MODS发生的危险因素(P<0.05)。结论 APACHEⅡ评分升高、合并慢性病、血肌酐水平升高、细菌培养阳性等促进脓毒症患者发展为MODS,早期监测这些因素并采取及时有效的控制措施可以提高脓毒症患者治愈率,降低病死率。Objective To explore the risk factors of multiple organ dysfunction syndrome（MODS）caused by sepsis.Methods The clinical data of 196 septic patients who were treated in our department from August 2006 to December 2009 were retrospectively analyzed.The univariate analysis and binary Logistic regression analysis were performed to screen the associated risk factors.Results Of these 196 patients,153 patients（78.1%）suffered from sepsis,among whom 7 patients（4.6%）died;43 patients（21.9 %）had MODS,among whom 27 patients（62.8%）died.The mortality rate was significantly different between the two groups（P〈0.05）.Univariate analysis showed that the risk factors included age,APACH Ⅱscore,serum creatinine,blood pH level,mean arterial pressure,blood sugar,chronic diseases,germiculture results,and electrolyte imbalance（P〈0.05）.Binary Logistic regression analysis identified four significant risk factors,which were APACH Ⅱscore,chronic diseases,creatinine,and germiculture.Conclusion APACH Ⅱ score,chronic diseases,serum creatinine,and positive germiculture results are risk factors of MODS caused by sepsis.

关 键 词：脓毒症 多器官功能衰竭 危险因素 

分 类 号：R714.626[医药卫生—妇产科学]