重症监护室脓毒症患者预后危险因素分析  

Analysis of prognostic risk factors in patients with sepsis in intensive care unit

作　　者：尚鑫 李强 向杰 范滨 董培贤 刘剑[2] 常靖 SHANG Xin;LI Qiang;XIANG Jie;FAN Bin;DONG Peixian;LIU Jian;CHANG Jing(Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021;the 989th Hospital of the Chinese People's Liberation Army,Pingdingshan 467000,China)

机构地区：[1]西安市中医医院,陕西西安710021 [2]中国人民解放军第九八九医院,河南平顶山467000

出　　处：《临床医学研究与实践》2022年第17期43-46,共4页Clinical Research and Practice

摘　　要：目的分析影响重症监护室脓毒症患者预后危险因素。方法回顾性选取2018年1月至2021年1月我院收治的64例脓毒症患者为研究对象,按照患者确诊14 d预后情况对其进行分组。收集所有患者的一般信息、基础生命体征指标及实验室检查指标。经单因素分析探索影响脓毒症患者预后的可能因素,并将差异具有统计学意义的因素纳入多因素Logistic回归分析,进而探索影响脓毒症患者预后的独立危险因素。结果按照确诊14 d预后情况可将患者分为生存组(n=36)及死亡组(n=28);生存组和死亡组的主要感染部位、性别、原发性高血压、糖尿病、冠心病发生情况及年龄比较,差异无统计学意义(P>0.05);生存组的APACHEⅡ评分显著低于死亡组,差异具有统计学意义(P<0.05);生存组的凝血酶原时间短于死亡组,差异具有统计学意义(P<0.05);生存组的血清肌钙蛋白I、血乳酸及谷草转氨酶水平低于死亡组,差异具有统计学意义(P<0.05);生存组和死亡组的C反应蛋白、白细胞计数、红细胞计数、红细胞比积、血小板计数、降钙素原、脑钠肽、血肌酐、尿素、血钾、血钙、血氯水平比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,APACHEⅡ评分、血清肌钙蛋白I为影响脓毒症患者预后的独立危险因素(P<0.05)。结论APACHEⅡ评分、血清肌钙蛋白I为影响脓毒症患者预后的独立危险因素,临床可根据二者评估患者病情,及时调整治疗方案,以便改善患者预后。Objective To analyze the risk factors that affect the prognosis of patients with sepsis in intensive care unit.Methods Sixty-four patients with sepsis admitted in our hospital from January 2018 to January 2021 were retrospectively selected as the research objects.The patients were grouped according to the prognosis at 14 d after diagnosis.The general information,basic vital signs and laboratory examination indexes of all patients were collected.The possible factors affecting the prognosis of patients with sepsis were explored by univariate analysis,and the factors with statistically significant differences were included in the multivariate Logistic regression analysis so as to explore the independent risk factors affecting the prognosis of patients with sepsis.Results According to the prognosis at 14 d after diagnosis,the patients were divided into survival group(n=36)and death group(n=28);there were no significant differences in the main infection site,gender,the occurence of primary hypertension,diabetes and coronary heart disease and age between the survival group and the death group(P>0.05);the APACHEⅡscore of the survival group was significantly lower than that of the death group,and the difference was statistically significant(P<0.05);the prothrombin time of the survival group was shorter than that of the death group,and the difference was statistically significant(P<0.05);the levels of serum troponin I,lactic acid and aspartate aminotransferase in the survival group were lower than those in the death group,and the differences were statistically significant(P<0.05);there were no significant differences in the levels of C-reactive protein,white blood cell,red blood cell count,hematocrit,platelet count,procalcitonin,brain natriuretic peptide,serum creatinine,urea,serum potassium,serum calcium and serum chlorine between the survival group and the death group(P>0.05).The multivariate Logistic regression analysis showed that APACHEⅡscore and serum troponin I were independent risk factors affecting prognosis

关 键 词：脓毒症 危险因素 APACHEⅡ评分 血清肌钙蛋白I 

分 类 号：R459.7[医药卫生—急诊医学]