持续脑电双频指数监测在脓毒症脑病患者中的应用价值  

Continuous BIS monitoring for patients with sepsis-associated encephalopathy

作　　者：赵丽姝[1] 张莉[1] 杨光虎[1] 

机构地区：[1]山东省胜利油田中心医院重症医学科,山东东营257000

出　　处：《中国现代医学杂志》2016年第6期123-126,共4页China Journal of Modern Medicine

摘　　要：目的探讨持续性脑电双频指数(BIS)监测在脓毒症脑病(SAE)患者中的临床应用价值。方法采取随机区组法,将山东省胜利油田中心医院2011年4月-2014月4月收治的116例脓毒症患者按是否为脑病患者分为脓毒症脑病组(SAE)及非脓毒症脑病组(非SAE),比较两组BIS、PCT、S100β蛋白、GCS分数及APACHE-II分数差异,并就BIS与GCS分数及APACHE-II分数进行Pearson相关性分析,同时对以上指标在患者的差异进行比较。结果 SAE组PCT值(8.453±3.442)μg/L及S100β蛋白值(0.775±0.356)μg/L均高于非SAE组(4.775±2.874)μg/L、(0.146±0.096)μg/L,差异具有统计学意义(P<0.05);同时,脓毒症脑病患者BIS与GCS及APACHE-II具有明显的相关性,相关系数分别为0.754及-0.657,而脓毒症患者则无明显相关性,此外,两组患者不同治疗结局下各项指数差异均具有统计学意义(P<0.05)。结论对脓毒症患者实施持续BIS监测有利于早期确诊患者是否并发脓毒症脑病,并对治疗预后起到一定的预判作用,同时BIS与GCS及APACHE-II具有较好的相关性,若配合PCT及S100β表达水平,则有助于准确评估患者病情。Objective To discuss the clinical value of continuous bispectral index（BIS） monitoring in patients with sepsis-associated encephalopathy. Methods Using random method, 116 sepsis patients treated in our hospital from Apr. 2011 to Apr. 2014 were divided into septic-encephalopathy（SAE） group and non-septic encephalopathy（nonSAE） group. The differences in BIS, procalcitonin（PCT）, S100β protein, Glasgow coma（GCS） score, and acute physiology and chronic health evaluation scoring system（APACHE-II） score were compared between the two groups. The correlations of BIS with GCS score and APACHE-II score were analyzed with Pearson correlation analysis. Results The PCT value [（8.453 ± 3.442） μg/L] and S100β protein value [（0.775 ± 0.356） μg/L] in the SAE group were significantly higher than those [（4.775 ± 2.874） μg/L and（0.146 ± 0.096） μg/L respectively] in the non-SAE group.BIS of the SAE patients was significantly correlated with GCS and APACHE-II（r = 0.754 and-0.657 respectively）,while such correlations were not found in the non-SAE patients. In addition, in the two groups the indexes were significantly different between the patients with different treatment outcomes（P〈0.05）. Conclusions Implementation of continuous BIS monitoring to patients with sepsis is conducive to early diagnosis of sepsis-associated encephalopathy and plays a role in predicting prognosis. At the same time BIS has good correlations with GCS and APACHE-II;combined with PCT and S100β expression levels, it helps to accurately assess the patient＇s condition.

关 键 词：脓毒症性脑病 脑电双频指数 APACHE-II分数 GCS分数 

分 类 号：R459.7[医药卫生—急诊医学]