脓毒症患者血红蛋白随病程变化的临床价值分析  

Analysis of Clinical Value of Hemoglobin Changes with the Course of Sepsis

作　　者：胡晨玲 沈旦[1] 王扬[1] 潘旭东[1] HU Chen-ling;SHEN Dan;WANG Yang;PAN Xu-dong(The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215031,China)

机构地区：[1]苏州大学附属第一医院,江苏苏州215031

出　　处：《中国血液流变学杂志》2022年第2期237-241,共5页Chinese Journal of Hemorheology

基　　金：苏州市科技计划项目(SYS2020098),苏州市重点扶持项目(SZFCXK202111)。

摘　　要：目的了解脓毒症患者血红蛋白(Hb)、Hb每日变化量随病程变化的特点,探讨Hb在脓毒症中的临床价值。方法回顾性收集2021年1月—2022年1月苏州大学附属第一医院重症医学科、呼吸与危重症医学科收治过程中符合纳入标准的病例43例,采集患者Hb、红细胞计数(RBC)等指标,根据是否休克分为休克组(n=16)和非休克组(n=27),根据是否死亡分为死亡组(n=13)和存活组(n=30),分析Hb、Hb每日变化量变化趋势,组间比较Hb及相关指标、序贯的器官衰竭评估评分(SOFA)、急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)等情况。结果脓毒症患者中36例发生贫血,7例未发生贫血,贫血发生率为83.7%;入院时已有贫血患者为21例,占总人数的48.8%;入院后新发贫血15例,占总人数的34.9%。入院第1天至第10天Hb变化呈现逐渐下降趋势,入院前3天Hb降低最快,并在第8至第10天逐渐趋向平稳,至第9天到达最低,第1天Hb与第9天Hb相比差异具有统计学意义(P=0.001)。休克组第3、4、5天Hb明显低于非休克组,差异具有统计学意义(P<0.05);休克组第1天Hb变化量明显大于非休克组,差异具有统计学意义(P<0.05);第6、7、9天中,存活组Hb显著高于死亡组,差异具有统计学意义(P<0.05);非休克组和存活组RBC显著高于休克组和死亡组,差异具有统计学意义(P<0.05)。结论脓毒症患者多合Hb的下降,并有下降趋势;Hb对脓毒症患者病情具有一定提示价值。Objective To investigate the characteristics of daily changes of hemoglobin(Hb)and Hb in patients with sepsis,and to explore the clinical value of Hb in sepsis.Methods 43 patients who met the inclusion criteria in the department of critical medicine and department of respiratory and critical care of the First Affiliated Hospital of Soochow University from January 2021 to January 2022 were collected.The patients were divided into shock group(n=16)and non-shock group(n=27)according to shock or not,and into death group(n=13)and survival group(n=30)according to died or not.The daily change trend of Hb and Hb was analyzed,and Hb and related indexes,sequential organ failure assessment score(SOFA),acute physiology and chronic health scoreⅡ(APACHEⅡ)were compared between the groups.Results Among the patients with sepsis,36 cases had anemia,7 cases had no anemia,and the incidence of anemia was 83.7%.There were 21 patients with anemia at the time of admission,accounting for 48.8%of the total,and 15 cases of new anemia after admission,accounting for 34.9%of the total.The change of Hb showed a gradual downward trend from the first day to the 10th day after hospitalization.The Hb decreased the fastest on the 3rd day before admission,gradually stabilized from the 8th to 10th day, and reached the lowest on the 9th day. There was a significant difference between Hb on the 1st day and Hb on the 9th day (P=0.001). On the 3rd, 4th and 5th day, the Hb in the shock group was significantly lower than that in the non-shock group (P<0.05), the change of Hb in the shock group on the 1st day was significantly higher than that in the non-shock group (P<0.05), and on the 6th, 7th and 9th day, the Hb in the survival group was significantly higher than that in the death group (P<0.05). The RBC in non-shock group and survival group was significantly higher than that in shock group and death group, and the difference was statistically significant (P<0.05). Conclusion The decrease of Hb in patients with sepsis has a downward trend, and Hb has

关 键 词：脓毒症 血红蛋白 贫血 

分 类 号：R631[医药卫生—外科学]