感染性休克患者血清CXCL-12水平变化及其对预后的影响  

The changes of serum CXCL-12 levels in patients with septic shock and its influence for prognosis

作　　者：于珊玲[1] 刘丰遂[1] 徐淑凤[2] 刘菲菲[2] 

机构地区：[1]河北省秦皇岛市第一医院重症医学二科,河北秦皇岛066000 [2]河北省秦皇岛市第一医院呼吸内一科,河北秦皇岛066000

出　　处：《中国医药导报》2018年第4期65-68,共4页China Medical Herald

基　　金：河北省秦皇岛市科学技术研究与发展计划项目(201401A251)

摘　　要：目的研究感染性休克患者血清趋化因子12(CXCL-12)水平变化及其对预后的影响。方法选择2016年8月~2017年5月在秦皇岛市第一医院住院接受治疗的感染性休克患者97例,其中生存者79例,死亡者18例。按照有无多器官功能障碍分为存在多器官功能性障碍(DF)组34例和无多器官功能性障碍组(NDF)63例。另选同期在医院进行健康体检的志愿者40例作为对照组,检测各组血清CXCL-12水平,不同预后患者血清CXCL-12及急性生理与慢性健康评分(APACHEⅡ),差异均有统计学意义(P<0.05)。分析患者死亡的影响因素。结果DF组和NDF组的血清CXCL-12水平均明显高于对照组,且DF组的血清CXCL-12及APACHEⅡ评分均明显高于NDF组,差异均有统计学意义(P<0.05)。生存组患者的血清CXCl-12及APACHEⅡ评分均明显低于死亡组,差异均有统计学意义(P<0.05)。Logistic回归分析显示,患者死亡的独立影响因素为CXCL-12及APACHEⅡ评分(P<0.05)。结论感染性休克患者的血清CXCL-12水平明显升高,并随着病情加重和预后恶化而继续上升。感染性休克患者死亡的独立影响因素为CXCL-12及APACHEⅡ评分,临床上应严格监测CXCL-12水平的变化,及时进行APACHEⅡ评分,从而能够更加科学而准确地评价感染性休克患者的预后。Objective To study the changes of serum CXCL-12 levels in patients with septic shock and its influence for prognosis. Methods From August 2016 to May 2017, 97 cases of septic shock patients treated in Qinhuangdao First Hospital were selected, including 79 cases of survivors and 18 cases of death. According to whether or not there were multiple organ functional disorder, they were divided into 34 patients with multiple organ functional disorder group （DF group） and 63 patients without multiple organ functional disorder group （NDF group）. Over the same period, 40 healthy volunteers were selected as the control group. Serum CXCL-12 levels were detected, serum CXCL-12 and APACHE 11 scores in different prognosis of patients were compared, influence factors of death were analyzed. Results The levels of serum CXCL,12 in DF group and NDF group were significantly higher than that of control group, and the level of serum CXCL-12 and the score of APACHE Ⅱ in the DF group were significantly higher than those in the NDF group, with statistically significant differences （P 〈 0.05）. The level of serum CXCL-12 and the score of APACHE Ⅱ in the survival group were significantly lower than those of the death group （P 〈 0.05）. The Logistic regression analysis showed that the influence factors of death in patients after treatment were CXCL-12 and APACHE Ⅱ score （P 〈 0.05）. Conclusion The level of serum CXCL-12 in patients with septic shock is significantly higher and continues to rise with the deterioration of illness and prognosis. CXCL-12 and APACHE H score are the independent risk factors of death of patients with septic shock. The change of CXCL-12 level in patients with septic shock should be strictly monitored, the APACHE Ⅱ score should evaluated timely. Thus, the prognosis of patients with septic shock can be evaluated more scientifically and accurately

关 键 词：感染性休克 血清趋化因子-12 APACHEⅡ评分 

分 类 号：R459.7[医药卫生—急诊医学]