摘要
目的探讨非泌尿外科术后尿源性脓毒症休克的危险因素及危险因素结合序贯器官衰竭评分(sequential organ failure assessment,SOFA)对该病的预测价值。方法回顾性收集2018年3月至2021年5月复旦大学附属中山医院收治的57例非泌尿外科术后尿源性脓毒症患者的一般临床资料和细胞因子水平。根据是否发生休克,将患者分为休克组(n=26)和非休克组(n=31),比较2组的临床特征。采用二分类logistic回归分析非泌尿外科术后尿源性脓毒症休克的危险因素,采用ROC曲线分析各参数预测非泌尿外科术后尿源性脓毒症休克的价值。结果与非休克组相比,休克组患者入院时SOFA评分及女性占比较高,多器官功能障碍综合征发生率较高,白细胞介素1β(interleukin-1β,IL-1β)、IL-8和IL-10水平较高。调整性别后,高水平IL-8(≥48 pg/mL)为非泌尿外科术后尿源性脓毒症休克的独立危险因素(OR=3.579,95%CI 1.084~11.813,P=0.036),与SOFA评分联合预测非泌尿外科术后尿源性脓毒症休克的价值最高(AUC=0.818,95%CI 0.707~0.928,P<0.001)。结论高水平IL-8(≥48 pg/mL)联合SOFA评分对非泌尿外科术后尿源性脓毒症休克有较好的预测效能,对于早期诊断和治疗该病具有临床指导价值。
Objective To explore the predictive value of risk factors combined with the sequential organ failure assessment(SOFA)for uroseptic shock without urological surgery.Methods The clinical data and cytokines levels of 57 patients with urosepsis without urologic surgery admitted to Zhongshan Hospital,Fudan University from March 2018 to May 2021 were retrospectively collected.They were divided into shock group and non-shock group according to whether shock occurred,and the clinical characteristics of patients in two groups were compared.The risk factors of uroseptic shock without urological surgery were analyzed by the binary logistic regression analysis,and the efficacy of each parameter in predicting the disease was analyzed by the receiver operating characteristic curve.Results Compared with the non-shock group,patients in the shock group had higher SOFA scores and female ratio at admission,multiple organ dysfunction syndrome incidence,and levels of interleukin-1β(IL-1β),IL-8,and IL-10.After adjusting for gender,high level of IL-8(≥48 pg/mL)was an independent risk factor for uroseptic shock without urological surgery(OR=3.579,95%CI 1.084-11.813,P=0.036),and it combined with SOFA scores was the most effective predictor of the disease(AUC=0.818,95%CI 0.707-0.928,P<0.001).Conclusion SOFA score combined with high level of IL-8(≥48 pg/mL)had a good predictive effect on the disease,which was of clinical value for early diagnosis and treatment of the disease.
作者
汪升
陈玉梅
邵勉
徐斐翔
童朝阳
薛明明
WANG Sheng;CHEN Yu-mei;SHAO Mian;XU Fei-xiang;TONG Chao-yang;XUE Ming-ming(Department of Emergency Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《中国临床医学》
2022年第3期437-441,共5页
Chinese Journal of Clinical Medicine
基金
国家自然科学基金(81800230)
复旦大学中山医院项目(2020ZSL37).
