摘要
目的观察贫血对机械通气患者预后的影响。方法采用前瞻陛研究方法，收集入住重症监护病房（ICU）预计机械通气时间≥72h，血红蛋白（Hb）浓度≥100g／L的患者。根据患者机械通气第313的Hb浓度分为贫血组和非贫血组。比较两组患者1、3、7d血清促红细胞生成素（EPO）、Fe3＋、转铁蛋白（TRF）水平，14d内人均输血量，3、7、14d内人均日采血量以及机械通气时间、28d脱机存活率、住院时间和28d病死率。结果共入选40例患者，贫血组18例，非贫血组22例。与非贫血组比较，贫血组患者血清Fe3＋较低，血清EPO、TRF较高；贫血组患者14d内人均输血量（u）较多[4．0（2．0，6．0）比2．0（0．0，2．O），P〈0．01]，ICU病死率较高（44．4％比13．6％，P〈0．05），住院时间（d）较长[35．0（16．5，51．6）比24．5（10．0，35．8），P〈0．05]，28d脱机存活率较低（44．4％比72．7％，P〈0．05）。而贫血组和非贫血组机械通气时间（d：18．3±10．8比11．6±8．2，P〉0．05）、ICU住院时间（d：16．5（8．0，21．5）比11．0（5．8，18．3），P〉0．05]和住院病死率（61．1％比31．8％，P〉0．05）比较差异无统计学意义。结论贫血患者机械通气时间及住院时间较长，ICU病死率较高，28d脱机存活率较低。
Objective To explore the prognostic effects of anemia among the mechanically ventilated patients. Methods A prospective observational study was undertaken in a 12-bed intensive care unit （ICU）. Patients requiring mechanical ventilation for at least 72 hours and hemoglobin （Hb） ≥100 g/L were enrolled. Serum erythropoietin （EPO）, Fe3＋, transferrin （TRF） levels were measured as baseline when they were enrolled and were repeated at day 3, 7 and 14. According to Hb concentration at day 3, patients were divided into anemia group （defined as Hb〈 100 g/L） and non-anemia group. Serum EPO, Fe3＋, TRF at day 1, 3 and 7, and mean amount of blood transfusion within 14 days, mean volume of blood drawn daily in 3, 7 and 14 days, the survival rate with unassisted breathing at day 28, ICU mortality, length of ICU stay, ventilator days, length of hospital stay and 28-day mortality were compared. Results Forty mechanically ventilated patients were enrolled and divided into anemia group （n = 18） and non-anemia group （n = 22）. It was shown that the anemia group had lower serum Fe3＋ concentration, and higher serum EPO and TRF. The anemia group also had more transfusion [U： 4.0 （2.0, 6.0） vs. 2.0 （0.0, 2.0）, P〈0.01], longer length of hospital stay （days： 35.0 （ 16.5, 51.6 ） vs. 24.5 （ 10.0, 35.8 ）, P〈 0.05 ], decreased rate of survival with unassisted breathing at day 28 （44.4% vs. 72.7%, P〈0.05 ） and higher ICU mortality （44.4% vs. 13.6%, P〈0.05 ）. But there were no significant differences between anemia group and control group in mechanical ventilated days （days： 18.3 ± 10.8 vs. 11.6± 8.2, P〉0.05）, length of ICU stay [days： 16.5 （8.0, 21.5） vs. 11.0 （5.8, 18.3）,P〉0.05] and hospital mortality （61.1% vs. 31.8%, P〉0.05）. Conclusion The anemic patients had longer ventilator days, hospital stay, higher ICU mortality, and lower rate of survival with unassisted breathing at day 28.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2012年第2期70-73,共4页
Chinese Critical Care Medicine
基金
北京市优秀人才培养项目（20071D0900700340）
关键词
机械通气
贫血
输血
预后
Mechanical ventilation
Anemia
Transfusion
Outcome
