低磷血症对铜绿假单胞菌所致呼吸机相关性肺炎患者预后的影响  

Effect of the concentration of serum phosphate on the prognosis of patients with pseudomonas aeruginosa induced ventilator associated pneumonia

作　　者：帅维正[1] 张志成[1] 钱扬会[2] 单毅[1] 刘于红[1] 李大伟[1] 邹剑峰[1] 胡子龙[1] 

机构地区：[1]解放军海军总医院ICU,北京100048 [2]解放军海军总医院检验科,北京100048

出　　处：《中国医药导报》2013年第30期61-63,共3页China Medical Herald

摘　　要：目的研究血磷水平对铜绿假单胞菌致病的呼吸机相关性肺炎（PAVAP）患者临床预后的影响。方法回顾性分析解放军海军总医院重症医学科2011年1月～2012年12月收治的36例PAVAP患者，记录其血磷、APACHE Ⅱ评分、预期病死率、28d内非机械通气时间、ICU住院时间以及实际病死率数据。根据血磷水平分为严重低磷血症组（pi≤0．3mmol／L）与对照组（pi〉0．3mmol／L），进行组间比较。结果严重低磷血症组患者病死率为38.4％，明显高于对照组患者（9．5％）（P〈0．05）。两组间APACHEll评分及28d内非机械通气时间比较差异均有统计学意义（均P〈0．05）。结论PAVAP伴严重低磷血症患者，病情较重，预后较差。血磷水平可作为判断其预后的简易指标之一。Objective To investigate the effect of the concentration of serum phosphate on the prognosis of patients with pseu-domonas aeruginosa induced ventilator associated pneumonia. Methods 36 patients with pseudomonas aeruginosa induced ventilator associated pneumonia in ICU of Navy General Hospital of PLA form January 2011 to December 2012 were analyzed retrospectively. The concentration of serum phosphate, acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） score, expected mortality, duration of without mechanical ventilation, length of ICU stay, actual mortality of the patients were recorded. All cases were divided into two groups： severe hypophosphatemia group （pi≤0.3 mmol/L） and controlled group （pi〉 0.3 mmol/L）. Results The results demonstrated that 38.4% of the patients with severe hypophosphatemia died, vs 9.5% of the patients without severe hypophosphatemia （P 〈 0.05）. There were significant differences of APACHE Ⅱ score and the dura- tion of without mechanical ventilation between the two groups （P 〈 0.05）. Conclusion The concentration of serum phosphate is correlated to the prognosis of patients with pseudomonas aeruginosa induced ventilator associated pneumonia, it may serve as an mortality predictor in these patients.

关 键 词：铜绿假单胞菌 呼吸机相关性肺炎 低磷血症 预后 

分 类 号：R563.1[医药卫生—呼吸系统]