超声心动图下右心室功能障碍对脓毒症患者早期预后的影响  

Effect of right ventricular dysfunction on early prognosis of sepsis patients under echocardiography

作　　者：夏楠 Xia Nan(Department of Ultrasound Diagnosis,Xinyang Central Hospital,Xinyang 464000,China)

机构地区：[1]河南省信阳市中心医院超声诊断科,464000

出　　处：《临床内科杂志》2024年第11期756-759,共4页Journal of Clinical Internal Medicine

摘　　要：目的探讨超声心动图下右心室功能障碍对脓毒症患者28 d死亡的预测价值。方法根据入院后28 d生存状况将263例脓毒症患者分为死亡组(61例)和生存组(202例),收集其基线资料及超声心动图检查结果并进行组间比较。采用多因素logistic回归分析探讨脓毒症患者28d死亡的影响因素。结果263例脓毒症患者入院28d死亡率为23.19%;右心室功能障碍发生率48.29%,其28 d死亡率为67.21%;左心室功能障碍发生率65.02%,其28 d死亡率为57.38%。与生存组比较,死亡组年龄、急性生理学和慢性健康状况评分系统(APACHEⅡ)评分及有创机械通气、糖尿病、高脂血症患者比例均较高,右心室面积变化分数、三尖瓣环收缩期位移、右心室心肌做功指数(RV-MPI)均较低(P<0.05)。多因素logistic回归分析结果显示,年龄≥60岁、APACHEⅡ评分>15分、有创机械通气、右心室功能障碍均是脓毒症患者28 d死亡的危险因素(P<0.05)。结论左心室功能障碍与脓毒症患者28 d死亡率无关,脓毒症合并右心室功能障碍患者28 d死亡率是未合并的3.159倍。Objective To investigate the value of right ventricle dysfunction under echocardiography in predicting 28 d death in patients with sepsis.Methods A total of 263 patients with sepsis were divided into death group(61 cases)and survival group(202 cases)according to their survival status 28 d after admission.Baseline data and echocardiographic results were collected and compared between groups.Multivariate logistic regression analysis was used to investigate the influencing factors of 28 d death in patients with sepsis.Results The mortality rate of 263 patients with sepsis was 23.19%at 28 d after admission.The incidence of right ventricular dysfunction was 48.29%,and the mortality rate of 28 d was 67.21%.The incidence of left ventricular dysfunction was 65.02%,and the mortality rate of 28 d was 57.38%.Compared with survival group,age,acute physiology,chronic health status scoring system(APACHEⅡ)score and the proportion of patients with invasive mechanical ventilation,diabetes and hyperlipidemia were higher in death group,right ventricle area change fraction,tricuspid ring systolic displacement and right ventricle myocardial work index(RV-MPI)were lower in death group(P<0.05).Multivariate logistic regression analysis showed that age≥60 years old,APACHEⅡscore>15 points,mechanical ventilation and right ventricle dysfunction were all risk factors for 28 d death in sepsis patients(P<0.05).Conclusion Left ventricular dysfunction was not associated with 28 d mortality in patients with sepsis.The mortality rate of 28 d in patients with sepsis complicated with right ventricular dysfunction was 3.159 times higher than that without sepsis.

关 键 词：超声心动图 右心室功能障碍 脓毒症 预后 

分 类 号：R540.45[医药卫生—心血管疾病] R331.31[医药卫生—内科学]