重症脓毒症休克患者预后影响因素的相关性分析  

Correlation analysis of the factors affecting the prognosis of patients with severe septic shock

作　　者：刘环芹[1] 万朝晖[2] LIU Huanqin;WAN Chaohui(Department of Critical Care Medicine,Jining First People’s Hospital,Shandong,Jining 272100,China;不详)

机构地区：[1]山东省济宁市第一人民医院重症医学科,272100 [2]山东省济宁市第一人民医院全科医学,272100

出　　处：《河北医药》2021年第22期3427-3430,共4页Hebei Medical Journal

摘　　要：目的探究影响重症脓毒症休克患者预后因素的相关性。方法利用便利抽样法从本院2019年4月至2020年6月收治的重症脓毒症患者中抽取满足纳入和排除标准的138例患者作为研究对象,并根据其有无发生脓毒性休克分为对照组和休克组,每组69例。根据有无病死分为生存组(n=79)和非生存组(n=59),使用一般资料调查表、急性生理学及慢性健康状况评分系统(APACHEⅡ)和序贯器官衰竭评分量表(SOFA)进行调查分析,并检测其入院后的血浆各指标水平[C-反应蛋白(CRP)、降钙素原(PCT)、白蛋白、血小板、乳酸],进而行统计学分析。结果休克组患者的APACHEⅡ、SOFA、CRP、PCT、乳酸和白细胞计数均显著高于对照组(P<0.05),休克组患者的血小板显著低于对照组(P<0.05)。非生存组患者的APACHEⅡ、SOFA、CRP、PCT、乳酸和白细胞计数均显著高于生存组(P<0.05),非生存组患者的血小板显著低于生存组(P<0.05)。重症脓毒症休克患者的APACHEⅡ与年龄、CRP、PCT、乳酸和白细胞计数呈正相关(r值分别为0.308、0.945、0.729、0.833、0.681,P<0.05),与血小板呈显著负相关。而SOFA与年龄、BMI、CRP、PCT、乳酸和白细胞计数呈正相关(r值分别为0.173、0.241、0.916、0.836、0.901、0.573,P<0.05),与血小板呈负相关(r=0.827,P<0.05)。结论影响重症脓毒症休克患者预后的因素为年龄、CRP、PCT、乳酸、血小板和白细胞计数,与年龄、CRP、PCT、乳酸、白细胞计数呈正相关,与血小板呈负相关。Objective To investigate the influencing factors on the prognosis of patients with severe septic shock.Methods A total of 138 patients with severe septic shock who were treated in our hospital from April 2019 to June 2020 were enrolled in the study.According to whether the patients had septic shock,who were divided into control group and shock group,with 69 cases in each group.Moreover the patients redivided into survival cases group and non-survival cases group.The general information questionnaire,acute physiology and chronic health status scoring system,and sequential organ failure scoring scale,and the plasma levels of CRP,PCT,albumin,platelet,lactic acid were observed and compared among groups.Results The APACHEⅡ,SOFA,and the levels of CRP,PCT,lactic acid and white blood cell counts in shock group were significantly higher than those in control group,however,the platelets were significantly lower than those in control group(P<0.05).The APACHEⅡ,SOFA,and the levels of CRP,PCT,lactic acid and white blood cell counts in non-survival case group were significantly higher than those in survival case group,but the platelets were significantly lower than those in survival case group(P<0.05).Moreover the APACHEⅡand SOFA in shock group were closely positively correlated with patient’s age,CRP,PCT,lactate and white blood cell count,howevere,which were closely negatively correlated with platelets(P<0.05).Conclusion The influencing factors on the prognosis of patients with severe septic shock are patient’s age,and the levels of CRP,PCT,lactic acid,platelet and white blood cell counts,which are positively correlated with age,CRP,PCT,lactate,and white blood cell counts,and negatively correlated with platelets.

关 键 词：脓毒症 重症 休克 急性生理学及慢性健康状况评分系统 序贯器官衰竭评分 预后 相关性 

分 类 号：R631.4[医药卫生—外科学]