脓毒症肺损伤中医证型与预后的相关性分析  

Correlation Analysis of TCM Syndromes and Prognosis of Sepsis-induced Lung Injury

作　　者：连新宝[1] 张宇 石姗 卢笑晖[1] LIAN Xinbao;ZHANG Yu;SHI Shan;LU Xiaohui(Department of Emergency and Critical Care Medicine,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Health and Family Planning Supervision Office of Huaiyin District,Jinan 250001,China)

机构地区：[1]山东中医药大学附属医院急诊重症医学科,山东济南250014 [2]济南市槐荫区卫生和计划生育监督所,山东济南250001

出　　处：《西部中医药》2024年第1期31-34,共4页Western Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划(2017-043)。

摘　　要：目的:分析脓毒症肺损伤中医证型与生存结局之间的相关性。方法:回顾性分析山东中医药大学附属医院急诊重症医学科确诊的脓毒症肺损伤住院患者病历,危险因素包括年龄、感染部位、既往史、最高体温、白细胞计数、降钙素原、血乳酸、急性生理与慢性健康评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ),通过Kaplan-Meier和单因素Cox比例风险回归分析比较中医证型及各危险因素与患者短期、长期预后的相关性。结果:热毒闭肺证、肺热腑实证、正虚喘脱证患者14天短期预后无明显差异(P=0.746),长期预后显示年龄、既往史、血乳酸、APACHEⅡ评分和中医辨证分型是影响脓毒症肺损伤患者预后的危险因素;肺热腑实证和正虚喘脱证死亡风险均高于热毒闭肺证(HR=4.127,95%CI[1.967,8.658],P<0.001;HR=5.455,95%CI[2.665,11.167],P<0.001),肺热腑实证与正虚喘脱证死亡风险比较无差异(OR=0.613,95%CI[0.272,1,387],P>0.05)。结论:中医证型与脓毒症肺损伤的预后具有相关性。Objective:To analyze the correlation between TCM syndromes and survival outcomes of sepsisinduced lung injury.Methods:A retrospective case-control study method was used to screen the inpatients diagnosed with sepsis-induced lung injury in the Department of Emergency and Critical Care Medicine,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,the correlation between TCM syndromes and various risk factors such as age,site of infection,the past history,maximum body temperature,WBC count,PCT,Lac,APACHEⅡscores,with short-term,long-term prognosis of patients was compared through Kaplan-Meier and univariate Cox proportional risk regression analysis.Results:No significant difference has been found in the 14-day prognosis between the patients with heat-toxin closing lung pattern,lung-heat and excess in the Fu-organs pattern,the pattern of dyspnea induced by healthy Qi deficiency(P=0.746),long-term prognosis displayed that age,past history,Lac,APACHEⅡscores,and syndrome differentiation and typing were the risk factors influencing the prognosis of the patients,the risk of death in patients of lung-heat and excess in the Fu-organs pattern,and the pattern of dyspnea induced by healthy Qi deficiency was higher than that in patients of heat-toxin closing lung pattern(HR=4.127,95%CI[1.967,8.658],P<0.001;HR=5.455,95%CI[2.665,11.167],P<0.001),and no difference had been found in the risk of death between lung-heat and excess in the Fu-organs pattern,and the pattern of dyspnea induced by healthy Qi deficiency(OR=0.613,95%CI[0.272,1.387],P>0.05).Conclusion:TCM syndromes are related to the prognosis of sepsis-induced lung injury.

关 键 词：脓毒症肺损伤 中医证型 相关性分析 Cox比例风险回归分析 

分 类 号：R256.13[医药卫生—中医内科学]