感染性休克患者预后的危险因素分析  

The risk factors analyse of prognosis in patients with septic shock

作　　者：徐潜[1] 林海[1] 姚明明 马耀[1] Xu Qian;Lin Hai;Yao Mingming(Department of Critical Care Medicine,Ma'anshan People's Hospital,Ma'anshan 243000,China)

机构地区：[1]马鞍山市人民医院重症医学科,243000

出　　处：《中华保健医学杂志》2020年第4期421-423,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的研究感染性休克患者预后的危险因素。方法选取2016年1月~2019年9月马鞍山市人民医院90例感染性休克患者作为研究对象,记录90例患者中死亡病例,并作为预后不良组,余患者作为预后良好组。比较两组患者基本资料和实验室指标水平,采用logistic多因素分析法分析感染性休克患者不良预后的高危因素。结果90例患者中死亡24例,为预后不良组,患者ICU治疗时间显著短于预后良好组患者,APACHEⅡ和SOFA评分均高于预后良好组,差异均有统计学意义(P<0.05)。预后不良组患者血乳酸清除率、血小板计数及白蛋白水平低于预后良好组,CRE、cTnⅠ及BNP均显著高于预后良好组,差异均有统计学意义(P<0.05)。logistic多因素分析显示APACHEⅡ评分(OR=2.062,P=0.000)、SOFA评分(OR=3.114,P=0.033)、cTnⅠ(OR=1.792,P=0.000)及BNP(OR=2.308,P=0.006)是感染性休克患者不良预后的危险因素(P<0.05),血乳酸清除率(OR=0.675,P=0.004)和白蛋白水平(OR=0.548,P=0.000)是其不良预后的保护因素(P<0.05)。结论感染性休克患者预后与患者APACHEⅡ评分、SOFA评分、心肌损伤标记物及白蛋白水平相关,临床应引起重视。Objective To study the risk factors of prognosis in patients with septic shock.Methods 90 patients with septic shock from January 2016 to September 2019 were selected.Among the subjects,the death cases of 90 patients were recorded and were used as the poor prognosis group,the rest were as good prognosis group.The basic data and laboratory indexes in the two groups were compared,the Logistic multivariate analysis was used to analyze the high risk factors of poor prognosis in patients with septic shock.Results There were 24 cases of died among the 90 patients,which were in poor prognosis group and 66 cases in good prognosis group.The treatment time in ICU in the poor prognos group was significantly shorter than that in the good prognosis group,the APACHEⅡand SOFA scores in the poor prognosis were higher than those in the good prognosis group,the difference were statistically significant(P<0.05).The serum lactate clearance rate,platelet count and albumin level in the poor prognosis group were lower than those in the good prognosis group,and the CRE,cTnⅠand BNP were significantly higher than those in the good prognosis group,the difference were statistically significant(P<0.05).The Logistic multivariate analysis showed that the APACHEⅡscore(OR=2.062,P=0.000),SOFA score(OR=3.114,P=0.033),cTnⅠ(OR=1.792,P=0.000)and BNP(OR=2.308,P=0.006)were risk factors for poor prognosis in septic shock patients(P<0.05),the serum lactate clearance rate(OR=0.675,P=0.004)and albumin level(OR=0.548,P=0.000)were the protective factors of poor prognosis(P<0.05).Conclusion The prognosis of septic shock patients is related to APACHEⅡscore,SOFA score,myocardial injury markers and albumin level,which should be paid more attention in clinic.

关 键 词：感染性休克 预后 危险因素 

分 类 号：R631.4[医药卫生—外科学]