血镁评估脓毒症患者预后的价值分析  

Value analysis of blood magnesium in evaluating the prognosis of sepsis patients

作　　者：殷俊 马娣[1] 洪峰[1] 周大勇[1] Yin Jun;Ma Di;Hong Feng;Zhou Dayong(Department of Comprehensive ICU,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院重症医学科,合肥230031

出　　处：《中国医师进修杂志》2025年第3期227-231,共5页Chinese Journal of Postgraduates of Medicine

基　　金：安徽省临床医学研究转化专项(202304295107020124)。

摘　　要：目的分析脓毒症患者的预后影响因素以及入院血镁评估预后的价值。方法回顾性分析安徽中医药大学第一附属医院2020年1月至2022年12月197例脓毒症患者的临床资料。院内死亡71例(死亡组),存活126例(存活组)。比较患者基础资料、机械通气、使用血管活性药物、住院时间、急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)、序贯器官衰竭评分(SOFA)、血常规、血气分析、血液生化指标和炎性因子水平。采用多因素非条件Logistic回归分析影响脓毒症患者死亡的独立危险因素。采用受试者工作特征(ROC)曲线评估相关指标预测脓毒症患者死亡的价值。结果死亡组心率、血小板计数、血镁、血钙、总胆固醇和D-二聚体明显低于存活组[86.0(75.0,105.0)次/min比91.5(80.0,115.7)次/min、(125.86±67.58)×109/L比(165.67±75.83)×109/L、0.64(0.57,0.71)mmol/L比0.76(0.69,0.86)mmol/L、2.21(2.19,2.29)mmol/L比2.34(2.22,2.39)mmol/L、3.40(2.68,3.91)mmol/L比3.68(2.99,4.39)mmol/L和1.23(0.65,2.76)mg/L比1.77(0.79,4.79)mg/L],APACHEⅡ、SOFA、红细胞容积分布宽度(RDW)和三酰甘油明显高于存活组[21(18,24)分比19(17,22)分、7(6,8)分比5(4,6)分、0.164(0.152,0.171)比0.143(0.132,0.154)和1.37(0.94,1.78)mmol/L比1.14(0.82,1.59)mmol/L],差异有统计学意义(P<0.05或<0.01);两组性别构成、年龄、体温、高血压、糖尿病、机械通气、使用血管活性药物、住院时间、pH值、乳酸、白细胞计数、中性粒细胞计数、淋巴细胞计数、红细胞压积、总胆红素、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、血钠、血钾、白蛋白、尿素氮、肌酐、脑利钠肽、降钙素原、C-反应蛋白、肝素结合蛋白和淀粉样蛋白A比较差异无统计学意义(P>0.05)。多因素非条件Logistic回归分析结果显示,高SOFA、RDW及低血小板计数、总胆固醇和血镁是影响脓毒症患者发生死亡的独立危险因素(OR=5.655、2.011、0.985、0.380和3.160,Objective To analyze the prognostic factors in patients with sepsis,and the value of admission blood magnesium in evaluating the prognosis.Methods The clinical data of 197 patients with sepsis from January 2020 to December 2022 in the First Affiliated Hospital of Anhui University of Chinese Medicine were retrospectively analyzed.Among them,71 patients died in the hospital(death group),and 126 patients survived(survival group).The basic information,mechanical ventilation,using vasoactive drug,length of hospital stay,acute physiology and chronic health evaluationⅡ(APACHEⅡ),sequential organ failure score(SOFA),blood routine,blood gas analysis,blood biochemical indexes and inflammatory factor levels were compared.Multivariate unconditioned Logistic regression was used to analyze the independent risk factors.The efficacy of relevant indexes in predicting the death in patients with sepsis was evaluated by the receiver operating characteristics(ROC)curve.Results The heart rate,platelet count,blood magnesium,blood calcium,total cholesterol and D-dimmer in death group were significantly lower than those in survival group:86.0(75.0,105.0)times/min vs.91.5(80.0,115.7)times/min,(125.86±67.58)×109/L vs.(165.67±75.83)×109/L,0.64(0.57,0.71)mmol/L vs.0.76(0.69,0.86)mmol/L,2.21(2.19,2.29)mmol/L vs.2.34(2.22,2.39)mmol/L,3.40(2.68,3.91)mmol/L vs.3.68(2.99,4.39)mmol/L and 1.23(0.65,2.76)mg/L vs.1.77(0.79,4.79)mg/L,the APACHEⅡ,SOFA,red blood cell volume distribution width(RDW)and triglycerides were significantly higher than those in survival group:21(18,24)scores vs.19(17,22)scores,7(6,8)scores vs.5(4,6)scores,0.164(0.152,0.171)vs.0.143(0.132,0.154)and 1.37(0.94,1.78)mmol/L vs.1.14(0.82,1.59)mmol/L,and there were statistical differences(P<0.05 or<0.01);there were no statistical difference in gender composition,age,body temperature,hypertension,diabetes,mechanical ventilation,using vasoactive drug,length of hospital stay,pH value,lactic acid,white blood cell count,neutrophil count,lymphocyte count,hematocrit,total bilirubin,

关 键 词：脓毒症 镁 预后 预测 

分 类 号：R459.7[医药卫生—急诊医学]