非典型睡眠与重症肺炎并发脓毒症患者近期预后的关系研究  

The relationship between atypical sleep and short-term prognosis in patients with severe pneumonia complicated with sepsis

作　　者：张沙沙 刘海玲[1] 李颖[1] 汪晶[1] 许艳 王琴 彭晓红[1] ZHANG Shasha;LIU Hailing;LI Ying;WANG Jing;XU Yan;WANG Qin;PENG Xiaohong(Second Department of Intensive Care Medicine,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China;ICU of Xinjiang Production and Construction Corps Hospital,Urumqi,Xinjiang 830092,China;ICU of Urumqi Maternal and Child Health Hospital in Xinjiang,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆医科大学第一附属医院重症医学二科,新疆乌鲁木齐830054 [2]新疆生产建设兵团医院ICU,新疆乌鲁木齐830092 [3]新疆乌鲁木齐市妇幼保健院ICU,新疆乌鲁木齐830001

出　　处：《临床肺科杂志》2024年第7期978-982,共5页Journal of Clinical Pulmonary Medicine

基　　金：新疆维吾尔自治区自然科学基金面上项目(No.2022D01C224)。

摘　　要：目的探讨非典型睡眠(AS)与重症肺炎(SP)并发脓毒症患者短期预后的关系,为该疾病的预后评估和疾病管理提供参考依据。方法收集196例SP并发脓毒症患者,采用多导睡眠图(PSG)评估睡眠状态。调查AS发生率,比较AS组(n=70)和非AS组(n=126)院内病死率。采用Logistic回归分析SP并发脓毒症患者院内死亡的影响因素。采用受试者工作曲线(ROC)分析AS联合其他指标对SP并发脓毒症患者院内死亡的预测价值。结果SP并发脓毒症患者AS发生率为35.7%,AS组院内病死率高于非AS组(40.0%vs 13.5%,P<0.05)。Logistic回归分析显示,急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分,OR=1.878)、序贯器官衰竭评分(SOFA评分,OR=4.495)、急性肾损伤(AKI,OR=14.042)、使用血管活性药物(OR=4.296)和AS(OR=9.557)均是SP并发脓毒症患者院内死亡的独立危险因素(P<0.05)。ROC分析显示,AS联合其他指标预测SP并发脓毒症患者院内死亡的曲线下面积(AUC)为0.979,敏感度和特异度为91.1%和96.0%。结论SP并发脓毒症患者的AS发生率高,AS是SP并发脓毒症患者院内死亡的危险因素,且AS联合其他指标能够很好地预测该疾病患者的院内死亡。Objective To explore the relationship between atypical sleep(AS)and short-term prognosis in severe pneumonia(SP)patients complicated with sepsis,and to provide a reference basis for prognosis evaluation and disease management of this disease.Methods 196 SP patients complicated with sepsis were collected and their sleep status was evaluated by using polysomnography(PSG).The incidence of AS was investigated and the in-hospital mortality was compared between the AS group(n=70)and the non-AS group(n=126).Logistic regression analysis was used to analyze the influencing factors of in-hospital death in SP patients complicated with sepsis.The predictive value of AS combined with other indicators of in-hospital mortality in SP patients complicated with sepsis was analyzed by using the receiver operating curve(ROC).Results The incidence of AS in SP patients complicated with sepsis was 35.7%,and the in-hospital mortality in the AS group was higher than that in the non-AS group(40.0%vs 13.5%,P<0.05).Logistic regression analysis showed that acute physiology and chronic health score II(APACHE II score,OR=1.878),sequential organ failure score(SOFA score,OR=4.495),acute kidney injury(AKI,OR=14.042),use of vasoactive drugs(OR=4.296)and AS(OR=9.557)were all independent risk factors for the in-hospital death in SP patients complicated with sepsis(P<0.05).ROC analysis showed that the area under the curve(AUC)of AS combined with other indicators for predicting in-hospital death in SP patients complicated with sepsis was 0.979,with sensitivity and specificity of 91.1%and 96.0%.Conclusion The incidence of AS in SP patients complicated with sepsis is high.AS is a risk factor for in-hospital death in SP patients complicated with sepsis,and AS combined with other indicators can effectively predict in-hospital death in patients with this disease.

关 键 词：非典型睡眠 重症肺炎 脓毒症 近期预后 

分 类 号：R563.1[医药卫生—呼吸系统] R459.7[医药卫生—内科学]