摘要
目的探讨急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和心肌损伤标志物与感染性休克患者预后的关系。方法选取2015年1月—2017年6月株洲市中心医院收治的感染性休克患者96例,根据近30 d预后分为存活组52例与死亡组44例。比较两组患者一般资料和心肌损伤标志物,感染性休克患者预后的影响因素分析采用多元Cox比例风险回归分析。结果两组患者性别、高血压病史、糖尿病病史、胆管结石病史、泌尿系统结石病史、基础疾病及血清氨基末端脑利钠肽前体(NT-pro BNP)水平比较,差异无统计学意义(P>0.05);死亡组患者年龄大于存活组,APACHEⅡ评分及血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、肌红蛋白(Mb)水平高于存活组(P<0.05)。多元Cox比例风险回归分析结果显示,APACHEⅡ评分[RR=2.296,95%CI(1.090,4.835)]及血清CK-MB[RR=3.391,95%CI(1.221,9.414)]、cTnT[RR=2.804,95%CI(1.016,7.739)]、Mb[RR=2.252,95%CI(1.074,4.725)]水平是感染性休克患者预后的独立影响因素(P<0.05)。结论 APACHEⅡ评分及血清CK-MB、cTnT、Mb水平均是感染性休克患者预后的独立影响因素,应引起临床重视。
Objective To investigate the relationship between APACHEⅡscore,myocardial injury markers and prognosis in patients with septic shock.Methods A total of 96 patients with septic shock were selected in the Central Hospital of Zhuzhou from January 2015 to June 2017,and they were divided into survival group(n=52)and death group(n=44)according to the 30-day prognosis.General information and myocardial injury markers were compared between the two groups,and multivariate Cox proportional risk regression analysis was used to analyze the influencing factors of prognosis in patients with septic shock.Results No statistically significant differences of gender,medical history of hypertension,diabetes,biliary calculi,urinary systematic calculi,underlying diseases or serum NT-proBNP level was found between the two groups(P>0.05);age in death group was statistically significantly elder than that in survival group,APACHEⅡscore,serum levels of CKMB,cTnT and Mb in death group were statistically significantly higher than those in survival group(P<0.05).Multivariate Cox proportional risk regression analysis results showed that,APACHEⅡscore〔RR=2.296,95%CI(1.090,4.835)〕,serum levels of CK-MB〔RR=3.391,95%CI(1.221,9.414)〕,cTnT〔RR=2.804,95%CI(1.016,7.739)〕and Mb〔RR=2.252,95%CI(1.074,4.725)〕were independent influencing factors of prognosis in patients with septic shock(P<0.05).Conclusion APACHEⅡscore,serum levels of CK-MB,cTnT and Mb are independent influencing factors of prognosis in patients with septic shock,which should pay attention to on clinic.
作者
龙云铸
李丹
傅京力
周青
赵韵华
谭英征
LONG Yun-zhu;LI Dan;FU Jing-li;ZHOU Qing;ZHAO Yun-hua;TAN Ying-zheng(Department of Infectious Diseases,the Central Hospital of Zhuzhou,Zhuzhou 412007,China)
出处
《实用心脑肺血管病杂志》
2018年第6期31-34,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
株洲市医药卫生"1
3
5"人才工程资助课题(ZW20140605)
