肺部感染致脓毒症患者脑功能障碍的危险因素分析  

Analysis of risk factors for brain dysfunction in patients with sepsis caused by pulmonary infection

作　　者：王泽帅 赵世龙[1] 刘秋红[1] WANG Ze-shuai;ZHAO Shi-long;LIU Qiu-hong(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院呼吸与危重症医学科,郑州450052

出　　处：《医药论坛杂志》2024年第13期1345-1348,共4页Journal of Medical Forum

基　　金：河南省医学科技攻关计划省部共建项目(SBGJ202102172)。

摘　　要：目的探讨肺部感染致脓毒症患者脑功能障碍的危险因素。方法选取2020年3月—2022年9月郑州大学第一附属医院收治的肺部感染致脓毒症患者142例,根据是否发生脓毒症所致脑功能障碍(sepsis induced brain dysfunction,SIBD)分为SIBD组77例与非SIBD组65例,比较两组一般资料与实验室指标,采用logsitic回归分析SIBD的独立危险因素。结果SIBD组脓毒症休克、机械通气、急性呼吸窘迫综合征患者比例以及ICU住院时间、SOFA评分、APACHEII评分高于非SIBD组(P<0.05);SIBD组血红蛋白低于非SIBD组,尿素氮、血肌酐、凝血酶原国际比值、降钙素原、S100β蛋白、神经元特异性烯醇化酶高于非SIBD组(P<0.05);SOFA评分(OR=1.583,95%CI:1.234~5.281)、GCS评分(OR=2.181,95%CI:2.358~9.731)、S100β蛋白(OR=1.324,95%CI:1.253~4.732)水平是肺部感染致脓毒症患者发生SIBD的独立危险因素(P<0.05)。结论SOFA评分、GCS评分、S100β蛋白水平是预测SIBD的主要危险因素,加强上述指标的动态监测,可能是预防SIBD发生、发展的有效措施。Objective To investigate the risk factors of brain dysfunction in patients with sepsis caused by pulmonary infection.Methods Totally 142 patients with sepsis due to pulmonary infection admitted from Mar.2020 to Sept.2022 were divided into sepsis induced brain dysfunction(SIBD)group(77 cases)and non-SIBD group(65 cases)according to whether SIBD occurred.General data and laboratory indicators of the two groups were compared.Independent risk factors for SIBD were analyzed by logsitic regression.Results The proportion of patients with septic shock,mechanical ventilation,acute respiratory distress syndrome,length of ICU stay,SOFA score and APACHEII score in SIBD group were higher than those in non-SIBD group(P<0.05).Hemoglobin in SIBD group was lower than that in non-SIBD group,urea nitrogen,serum creatinine,prothrombin international ratio,procalcitonin,S100βprotein and neuron specific enolase were higher than those in non-SIBD group(P<0.05).OFA score(OR=1.583,95%CI:1.234~5.281),GCS score(OR=2.181,95%CI:2.358~9.731),S100βprotein(OR=1.324,95%CI:1.253~4.732)levels were an independent risk factor for SIBD in patients with sepsis due to pulmonary infection(P<0.05).Conclusion SOFA score,GCS score and S100βprotein level are the main risk factors for predicting SIBD.Strengthening the dynamic monitoring of these indicators may be an effective measure to prevent the occurrence and development of SIBD.

关 键 词：肺部感染 脓毒症 脑功能障碍 临床特征 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]