毛细血管再充盈时间对脓毒性休克患者预后价值  

Prognostic Value of Capillary Refill Time in Patients with Septic Shock

作　　者：李晓倩 马玉仓 曹磊[1] 唐伟伟 白兆青 LI Xiao-qian;MA Yu-cang;CAO Lei;TANG Wei-wei;BAI Zhao-qing(Department of Emergency,Anqing Medical Center of Anhui Medical University(Anqing MunicipalHospital),Anqing 246000,China)

机构地区：[1]安徽医科大学安庆医学中心(安庆市立医院)急诊科,安庆246000

出　　处：《微循环学杂志》2023年第1期71-75,共5页Chinese Journal of Microcirculation

基　　金：安徽省安庆市科学技术局科技计划项目(2021Z2015)。

摘　　要：目的:分析毛细血管再充盈时间(CRT)对脓毒性休克患者预后的价值。方法:回顾性查阅2021-01—2022-01本院收治的脓毒性休克患者临床病历资料,根据其中80例患者28天转归,分为生存组(n=42)和死亡组(n=38),两组均进行集束化综合治疗,并检查记录治疗前和治疗后6h CRT及其它临床指标数据。采用Logistic回归分析CRT及临床资料对患者预后的影响,通过受试者工作特征曲线(ROC)预判CRT对患者28d死亡风险。结果:死亡组年龄、性别、白细胞计数(WBC)、血尿素氮(BUN)、肌酐(Scr)、门冬氨酸氨基转移酶(AST)、24h内序贯器官衰竭评分(SOFA)、治疗后6h CRT与生存组比较,差异均有统计学意义(P<0.05或P<0.01);Logistic回归分析显示,患者年龄、性别、WBC、BUN、Scr、SOFA评分和治疗后6h CRT是脓毒性休克患者死亡的危险因素,其中WBC、SOFA、治疗后6h CRT是独立危险因素。ROC表明治疗后6h CRT为3.15s时,预测脓毒性休克患者28天死亡的灵敏度为68.4%,特异度为71.4%,曲线下面积(AUC)0.71(95%CI:0.59-0.82)。结论:集束化综合治疗后6h CRT延长是脓毒性休克患者的独立危险因素,对脓毒性休克预后有良好预测价值。Objective: To evaluate the prognostic value of capillary refill time(CRT) in patients with septic shock. Method: Clinical medical records of patients with septic shock admitted to our hospital from January 2021 to January 2022 were retrospectively reviewed. According to the 28d outcome of 80 patients, they were divided into survival group(n=42) and death group(n=38). Both groups received bunching comprehensive treatment, and 6h CRT and other clinical indicators were examined and recorded before and after treatment. The effects of CRT and clinical data on the prognosis of patients were analyzed by Logistic regression, and the 28d mortality risk of CRT was predicted by ROC. Results: There were statistically significant differences in age, gender, WBC, BUN, Scr, AST, SOFA score, 6h CRT after treatment between the death group and the survival group(P<0.05 or P<0.01). Logistic regression analysis showed that age, gender, WBC, BUN, Scr, SOFA score and 6h CRT after treatment were risk factors for death in patients with septic shock, and WBC, SOFA and 6h CRT after treatment were independent risk factors. ROC showed that when 6h CRT was 3.15s after treatment, the sensitivity and specificity of predicting 28d death in septic shock patients was 68.4%, 71.4%, and the area under the curve was 0.71(95%CI: 0.59-0.82). Conclusion: The increase of 6h CRT after combined bunching therapy is an independent risk factor for septic shock patients and has good prognostic value for septic shock.

关 键 词：脓毒性休克 毛细血管再充盈时间 预后 

分 类 号：R459.7[医药卫生—急诊医学]