脓毒症患者微量白蛋白尿与肺损伤的关系  

Relation between microalbuminuria and lung injury in septic patients

作　　者：江皓波[1] 劳美铃[1] 马明远[1] 

机构地区：[1]广东省佛山市中医院重症医学科,528000

出　　处：《实用医学杂志》2015年第1期67-69,共3页The Journal of Practical Medicine

基　　金：广东省建设中医药强省科研课题(编号:20131058);广东省佛山市卫生局科研立项课题(编号:2013124)

摘　　要：目的:探讨尿白蛋白肌酐比值(UACR)与脓毒症所致肺损伤的关系。方法:共98例脓毒症患者纳入研究,收治后6 h内检测并计算UACR、氧合指数(OI);通过Pi CCO系统监测血管外肺水指数(EVLWI)、肺血管通透性指数(PVPI)。比较EVLWI正常组与增高组PVPI、OI、UACR的差异,是否需机械通气患者EVLWI、PVPI、UACR的差异。分析UACR与EVLWI、PVPI、OI的相关性。结果:EVLWI增高组PVPI、UACR高于正常组,OI低于正常组,差异均有统计学意义(P<0.05)。UACR与EVLWI、PVPI正相关,与OI负相关(P<0.05)。需机械通气患者的EVLWI、PVPI、UACR高于非机械通气患者,差异均有统计学意义(P<0.05)。结论 :在部分脓毒症患者,UACR可预测脓毒症所致肺水肿的形成,可尝试用于评估肺损伤的严重程度。Objective To investigate the relationship between urine albumin creatinine ratio（UACR） and sepsis-induced lung injury. Methods UACR, OI, EVLWI and PVPI were detected within 6 hours after admission. These parameters were compared between patients with high EVLWI and normal EVLWI, and the ventilated patients and the non-ventilated patients. Results In patients with high EVLWI, levels of UACR and PVPI were significantly increased, OI level was significantly reduced （P 〈 0.05, respectively）. Level of UACR was positively correlated with EVLWI and PVPI, and was negatively correlated with OI （P 〈 0.05, respectively）. Levels of EVLWI, PVPI and UACR were significantly elevated in the ventilated patients （P 〈 0.05, respectively）. Conclusion To some septic patients, UACR can be used to predict sepsis-induced pulmonary edema, and can be used to evaluate the severity of lung injury.

关 键 词：尿白蛋白肌酐比值 脓毒症 血管外肺水指数 肺血管通透性指数 氧合指数 

分 类 号：R459.7[医药卫生—急诊医学]