老年脓毒症患者并发肝功能不全的危险因素分析  

Risk factors analysis on sepsis complicated with hepatic insufficiency in elder patients

作　　者：翁志雄[1] 余志金[2] 龙国清[3] 叶初阳[4] 陈惠新[2] 刘志红[1] 

机构地区：[1]广东省惠州市中心人民医院急救与创伤中心,516001 [2]广东省惠州市中心人民医院消化内科,516001 [3]广东省惠州市中心人民医院病案统计室,516001 [4]广东省惠州市中心人民医院重症医学科,516001

出　　处：《中国医师进修杂志》2014年第17期1-4,共4页Chinese Journal of Postgraduates of Medicine

基　　金：广东省惠州市科技计划（20130801）

摘　　要：目的探讨老年脓毒症患者并发肝功能不全的危险因素。方法采用病例一对照研究方法入选384例老年脓毒症患者，其中住院期间发生肝功能不全91例（病例组），未发生肝功能不全293例（对照组），对各种可能导致肝功能不全的相关危险因素进行单因素和多因素Logistic回归分析。结果单因素分析结果显示，年龄、饮酒史、慢性基础病、动脉血乳酸、机械通气和急性生理学与慢性健康状况评分Ⅲ（APACHE-Ⅲ）是老年脓毒症患者并发肝功能不全的危险因素（P〈0．01或〈0．05）；多因素Logistic回归分析结果显示，年龄、饮酒史、慢性基础病、动脉血乳酸、机械通气和APACHE-Ⅲ是老年脓毒症患者并发肝功能不全的高危因素（P〈0．01或〈0．05）。结论年龄、饮酒史、慢性基础病、动脉血乳酸、机械通气和APACHE-Ⅲ是老年脓毒症患者并发肝功能不全的高危因素。Objective To explore the risk factors of sepsis complicated with hepatic insufficiency in elder patients. Methods With retrospective case-control study method, according to whether or not complicated with hepatic insufficiency, a total of 384 elder sepsis patients were divided into case group （91 patients） and control group（293 patients）, then single factor analysis and muhiple factors Logistic regression methods were used to screen the risk factors. Results Single factor analysis identified 6 kinds of significant variables, including age（P = 0.000）, history of alcohol（P = 0.006）, chronic diseases（P = 0.001 ）, arterial blood lactate level（P = 0.035 ）, mechanical ventilation（P = 0.009） and acute physiology and chronic health evaluation Ⅲscore （APACHE-Ⅲ） scores（P = 0.004）. Multiple factors Logistic regression analysis showed that age, history of alcohol, chronic diseases, arterial blood lactate level, mechanical ventilation, APACHE-Ⅲ scores were correlated with sepsis complicated hepatic insufficiency in elder patients （P 〈 0.01 or 〈 0.05 ）. Conclusion The risk factors which closely relate to sepsis complicated with hepatic insufficiency in elder patients are age, history of alcohol, chronic diseases, arterial blood lactate level, mechanical ventilation, APACHE-Ⅲ scores.

关 键 词：老年人 脓毒症 肝功能不全 危险因素 

分 类 号：R459.7[医药卫生—急诊医学]