摘要
目的在严重感染患者中评价血脂与炎症递质的相关性、血脂的动态变化及其对死亡的预测作用。方法连续收集51例严重感染患者，前瞻性观察入ICU第1、3、7、14天的血脂水平、人ICU第1天的血清白细胞介素6（IL-6）和肿瘤坏死因子d（TNF—d）水平，分析血脂与炎症递质的相关性，并比较血脂在死亡组与存活组之间的差异。用受试者工作特征曲线（ROC曲线）分析血脂对死亡的预测价值。结果入ICU第1天患者的血清HDL—C水平与血清IL-6及TNF-α水平呈负相关（r=-0．75，P〈0．01；r=-0．71，P〈0．01），人ICU第1天的血清LDL—C水平同样与血清IL-6及TNF—α水平呈负相关（r=-0．68，P〈0．01；r=-0．70，P〈0．01）。人ICU后第1天的HDL—C在死亡组中（中位数0．42mmol／L）明显低于存活组（中位数0．63mmol／L，P〈0．01），差异在第3天（P〈0．01）、第7天（P〈0．05）和第14天（P〈0．01）持续存在；死亡组的LDL．C同样在入ICU后第1天（中位数0．68mmol／L）明显低于存活组（中位数1．13mmol／L，P〈0．05），差异在第3天（P〈0．05）、第7天（P〈0．05）和第14天（P〈0．05）也同样持续存在；ROC曲线分析显示。人ICU后第1天的HDL—C和LDL-C水平对死亡有预测意义。结论在严重感染患者中，血清HDL-C和LDL—C水平与炎症递质水平呈负相关，并对死亡有预测意义。
Objective To evaluate the correlation between lipids and inflammatory factors; to observe the dynamic variations and predictive values of lipids in serious infection patients. Methods Prospectively 51 serious infection patients were observed. Serum lipids were measured at 1st, 3th, 7th and 14th day after admitting to the intensive care unit （ICU）. Serum tumor necrosis factor-a（TNF-ot） and interleukin-6 （IL-6） were measured at first day after admitting to ICU. The data of clinical features and hospital mortality were collected. The patients were divided into survival group and non-suivival group. The correlation between lipids and inflammatory factors, and the dynamic variation of serum lipids levels were all observed between two groups. Results On the first day, high density lipoprotein-cholesterol （ HDL-C ） levels were correlated inversely with IL-6 （ r = - O. 75 ; P 〈 0.01 ） and TNF-ct（ r = -0.71; P 〈 0.01 ）. Low density lipoprotein-cholesterol （LDL-C） levels were also correlated inversely withlL-6（r= -0.68; P〈0.01）and TNF-ct（r = -0.70; P〈0.01）. HDL-C levels at the first day were significantly lower in hospital non-survivors （median, 0. 42 mmol/L ） compared with survivors （median, 0.63 mmol/L ; P 〈 0. 01 ）, and the differences were still significant on 3th （ P 〈 0.01 ）, 7th （ P 〈 0.05 ） and 14th day（P 〈 0.01 ）. Low density lipoprotein-eholesterol （LDL-C） levels at lth day were also significantly lower in hospital non-survivors （median, O. 68 mmol/L） compared with survivors （median, 1.13 mmol/L, P 〈 0.05）, and the differences were still significant on at 3th （ P 〈 0.05 ）, 7th （ P 〈 0.05 ） and 14th days （ P 〈 0.05 ）. HDL-C and LDL-C levels at the first day had prognostic values of mortality via receiver operating characteristic （ ROC ） curves analysis. Conclusions In serious infection patients, HDL-C and LDL-C levels correlate inversely with inflammatory factors. HDL-C and LDL-C are valuable prognostic fact
出处
《中国医药》
2012年第12期1503-1505,共3页
China Medicine
关键词
严重感染
血脂
高密度脂蛋白胆固醇
低密度脂蛋白胆固醇
Serious infection
Lipids
High density lipoprotein-cholesterol
Low density lipoprotein-cholesterol
