感染性休克患者血浆D-乳酸、肝素结合蛋白水平与APACHEⅡ评分的相关性分析  

Analysis of Correlations between Plasma D-lactic Acid and Heparin Binding Protein Levels and APACHE Ⅱ Score in Patients with Septic Shock

作　　者：苏爱峰[1] 李云[2] SU Aifeng;LI Yun(Nanyang Second General Hospital,Nanyang City,He’nan Province 473012)

机构地区：[1]河南省南阳市第二人民医院呼吸重症监护室,473012 [2]河南省南阳市第二人民医院内分泌科,473012

出　　处：《医学理论与实践》2022年第18期3064-3067,共4页The Journal of Medical Theory and Practice

摘　　要：目的:检测感染性休克患者血浆中D-乳酸(D-Lac)、肝素结合蛋白(HBP)水平,同时对患者进行急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分,并探讨感染性休克患者血浆D-Lac、HBP水平与APACHEⅡ评分的关系。方法:选取2016年2月—2019年1月因感染性休克于本院住院的89例患者为研究对象(感染性休克组);同期选取83例健康体检者作为对照(对照组)。采用血乳酸分析仪检测两组血浆中D-Lac水平、酶联免疫吸附法(ELISA)检测血浆中HBP水平,对患者APACHEⅡ评分进行评定;分析两组一般资料;分析感染性休克患者血浆中D-Lac、HBP水平与APACHEⅡ评分的相关性;分析感染性休克患者D-Lac、HBP及APACHEⅡ评分与血流动力学参数的相关性;分析影响感染性休克的因素。结果:感染性休克组D-Lac、HBP、APACHEⅡ评分、PaCO_(2)均显著高于对照组,PaO_(2)、SaO_(2)低于对照组(P<0.05);感染性休克患者血浆中D-Lac、HBP水平与APACHEⅡ评分均呈正相关(P<0.05);感染性休克患者D-Lac、HBP、APACHEⅡ评分与PaCO_(2)呈正相关,与PaO_(2)、SaO_(2)均呈负相关(P<0.05);D-Lac、HBP是影响感染性休克的危险因素,PaO_(2)是影响感染性休克的保护因素。结论:感染性休克患者血浆D-Lac、HBP水平与APACHEⅡ评分均呈正相关,三者与感染性休克患者病情密切相关。提示血浆D-Lac、HBP水平对感染性休克的早期危险性有重要意义,临床上除APACHEⅡ评分外,还可将血浆D-Lac、HBP作为辅助诊断指标。Objective:To detect the levels of D-lactate(D-Lac)and heparin binding protein(HBP)in plasma of patients with septic shock,to score patients with acute physiology and chronic health scoreⅡ(APACHEⅡ),and to evaluate the relationships between the levels of D-Lac,HBP and APACHEⅡin plasma of patients with septic shock.Methods:89 patients with septic shock hospitalized in our hospital from February 2016 to January 2019 were selected as the study subjects(septic shock group),and 83 healthy people were selected as the control group during the same period.Blood lactate analyzer was used to detect D-Lac level in plasma of the two groups,enzyme-linked immunosorbent assay(ELISA)was used to detect HBP level in plasma,and APACHEⅡscore was evaluated;the general data of the two groups were analyzed;the correlations between plasma D-Lac,HBP levels and APACHEⅡscore in septic shock patients were analyzed;the correlations between D-Lac,HBP,APACHEⅡscore and hemodynamic parameters in septic shock patients were analyzed;and the factors affecting septic shock were analyzed.Results:D-Lac,HBP,APACHEⅡscore and PaCO_(2)in septic shock group were significantly higher than those in control group,while PaO_(2)and SaO_(2)were significantly lower than those in control group(P<0.05);the plasma D-Lac and HBP levels were positively correlated with APACHEⅡscore in septic shock patients(P<0.05);the D-Lac,HBP and APACHEⅡscore in septic shock patients were positively correlated with PaCO_(2),and negatively correlated with PaO_(2)and SaO_(2)(P<0.05);D-Lac and HBP were the risk factors of septic shock,and PaO_(2)was the protective factor of septic shock.Conclusion:The plasma D-Lac and HBP levels in patients with septic shock are positively correlated with APACHEⅡscore,and they are closely related to the condition of septic shock patients.It is suggested that plasma D-Lac and HBP levels are important for the early risk of septic shock.In addition to APACHEⅡscore,plasma D-Lac and HBP can also be used as auxiliary diagnostic indicators.

关 键 词：感染性休克 血浆 D-乳酸 肝素结合蛋白 APACHEⅡ评分 

分 类 号：R446[医药卫生—诊断学]