性激素对妊娠合并脓毒症患者早期预后的影响  

Effect of sex hormones on the prognosis of pregnant women with early sepsis

作　　者：戚伟珍 徐丽丽[1] 

机构地区：[1]温州医科大学附属东阳医院妇产科,浙江东阳322100

出　　处：《中国急救医学》2015年第6期495-497,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的：讨论雌二醇、睾酮水平对妊娠合并脓毒症患者预后的影响。方法选取我院2012－12～2014－12产科ICU收治妊娠合并脓毒症患者39例。根据患者28 d生存情况分为生存组29例和死亡组10例，比较两组雌二醇、睾酮水平、年龄、体质量指数（ BMI）、APACHEⅡ评分和SOFA评分等临床指标，评价各指标对患者预后的预测价值。结果生存组血清雌二醇水平高于死亡组，睾酮水平、APACHEⅡ评分和SOFA评分均低于死亡组，差异有统计学意义（ P均＜0．05）。患者年龄、BMI等差异无统计学意义（P＞0．05）。通过Logistic回归分析及ROC曲线显示，血清睾酮水平、APACHEⅡ评分和SOFA评分是妊娠合并脓毒症早期患者预后的独立危险因素，且均对脓毒症患者预后有较好的预测价值，临界点为血清睾酮水平0．64 pmol／L时，敏感度（86％）、特异度（84％）最高。结论性激素水平对妊娠合并脓毒症早期患者的预后有显著影响，睾酮水平可作为预测妊娠合并脓毒症早期患者预后的临床指标。Objective To investigate whether the estradiol, testosterone levels affect the prognosis of pregnant patients with early sepsis. Methods Thirty -nine pregnant patients who accompanied with sepsis from Dec 2012 to Dec 2014 in obstetric ICU of our hospital were selected in this study.According to patients with 28 d survival situation, 10 cases were included into survival group and 29 cases were included into death group.The data between the two groups were analyzed, including the level of estradiol and testosterone, age, body mass index （ BMI ） and APACHEⅡ scores, clinical indexes such as SOFA score, evaluation of each index forecast the prognosis of patients with valid values.Results Serum estradiol level in the survival group was higher than that in the death group, but serum testosterone level, APACHEⅡscore, SOFA scores were lower in the survival group than those in the death group, the difference was statistically significant （P 〈0.05）.There were no significant statistical difference in age, BMI of the patients（P〉0.05）.ROC curve by Logistic regression analysis has shown that the serum testosterone level, APACHEⅡ scores, SOFA score were independent risk factors for the prognosis of pregnant patients with early sepsis, and they can well predict the prognosis. The critical point for serum testosterone level was 0.64 pmol/L with a sensitivity of 86% and a specificity of 84% which was highest among the above mentioned risk factors.Conclusion Sex hormone levels in pregnant patients with early sepsis have remarkable effect on the prognosis.And we recommend the serum testosterone level to be a clinical indicator for predicting the prognosis of pregnant patients with early sepsis.

关 键 词：雌二醇 睾酮 妊娠 脓毒症 预后 

分 类 号：R572[医药卫生—消化系统]