脓毒症继发急性肺损伤的临床特征及预后影响因素分析  

Clinical features and prognostic influencing factors of acute lung injury secondary to sepsis

作　　者：范风江[1] Fan Fengjiang(Department of General Intensive Care Unit,Nanyang First People’s Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市第一人民医院综合ICU,473000

出　　处：《中国实用医刊》2021年第1期43-46,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析脓毒症继发急性肺损伤的临床特征及预后的影响因素。方法纳入2017年1月至2019年1月南阳市第一人民医院收治的55例脓毒症继发急性肺损伤患者作为观察组,同期按照1∶1原则纳入55例脓毒症未继发急性肺损伤患者作为对照组,比较两组临床资料,并观察继发急性肺损伤患者的临床特征。以病死或出院作为判定预后情况的标准,将脓毒症继发急性肺损伤病死患者纳入预后不良组,出院的患者纳入预后良好组,分析脓毒症继发急性肺损伤预后不良的影响因素。结果观察组肺损伤评分、急性生理学及慢性健康状况评分系统评分均高于对照组,肺水肿、呼吸急促等症状占比高于对照组,且凝血酶原时间、活化部分凝血活酶时间、凝血酶时间长于对照组,纤维蛋白原水平低于对照组,差异有统计学意义(P<0.05)。本研究纳入的55例脓毒症继发急性肺损伤患者中,9例患者出现预后不良,发生率为16.36%,高龄、多器官功能衰竭、氧合指数(OI)表达下调、肿瘤坏死因子-α(TNF-α)过表达、白细胞介素-6(IL-6)过表达均是脓毒症继发急性肺损伤预后不良的影响因素。结论脓毒症继发肺损伤存在肺水肿、呼吸急促、凝血功能异常等临床特征,且高龄、多器官功能衰竭、OI低表达、TNF-α高表达、IL-6高表达均可能提示脓毒症继发急性肺损伤预后不良风险。Objective To analyze the clinical characteristics and prognostic influencing factors of acute lung injury secondary to sepsis.Methods A total of 55 patients with acute lung injury secondary to sepsis admitted to Nanyang First People’s Hospital from January 2017 to January 2019 were included into the observation group.In the same period,55 patients with sepsis,but without acute lung injury,in the hospital were allocated into the control group according to the 1∶1 principle.The baseline data of the two groups were compared to observe the clinical characteristics of patients with lung injury secondary to sepsis.Death or discharge from hospital was taken as the criteria for determining prognosis.Patients who died of acute lung injury secondary to sepsis were included in the poor prognosis group,and the discharged patients were included in the good prognosis group.The influencing factors of the poor prognosis of acute lung injury secondary to sepsis were analyzed.Results The lung injury score(LIS)and acute physiology and chronic health evaluationⅡ(APACHEⅡ)score of the observation group were higher than those of the control group(P<0.05).The proportion of symptoms,such as pulmonary edema and shortness of breath,of the observation group was higher than that of the control group(P<0.05).The prothrombin time,activeated partial thromboplasting time,and thrombin time of the observation group were longer than those of the control group,and the fibrinogen level was lower than that of the control group(P<0.05).Among the 55 patients with acute lung injury secondary to sepsis included in this study,9 patients had a poor prognosis,with an incidence of 16.36%.Older age,multiple organ failure,down-regulation of oxygen index(OI)expression,over-expression of tumor necrosis factor-α(TNF-α),and over-expression of interleukin-6(IL-6)were all influencing factors for the poor prognosis of acute lung injury secondary to sepsis.Conclusions The clinical features of acute lung injury secondary to sepsis include pulmonary edema,short

关 键 词：脓毒症 急性肺损伤 临床特征 预后 多器官功能衰竭 年龄 

分 类 号：R459.7[医药卫生—急诊医学] R563[医药卫生—治疗学]