摘要
目的探讨分析脓毒症早期血清白蛋白表达水平,揭示血清白蛋白水平对判断脓毒症短期预后的临床意义。方法 112例脓毒症患者,将并发脓毒性休克的49例患者作为脓毒性休克组,将非脓毒性休克的63例患者作为脓毒症组。从医院电子病历数据库获得所有入组患者的临床资料。收集患者入住重症医学科24 h内临床参数(年龄、性别、疾病、血常规、降钙素原、血生化全项和血气分析),并计算出急性生理和慢性健康评分(APACHEⅡ)评分及28 d内生存情况等。比较脓毒症组患者与脓毒性休克组患者血清白蛋白水平相关参数值变化及血清白蛋白水平与患者短期预后的相关性。结果两组患者发病时间比较差异有统计学意义(P<0.05)。脓毒症组血清总蛋白为(59.24±7.76)g/L,高于脓毒性休克组的(54.01±9.31)g/L(P<0.05);白蛋白为(31.36±5.80)g/L,高于脓毒性休克组的(26.08±7.20)g/L(P<0.05);前白蛋白为(114.58±69.01)mg/L,高于脓毒性休克组的(75.73±58.98)mg/L(P<0.05)。两组APACHEⅡ评分、乳酸及28 d内生存情况比较差异有统计学意义(P<0.05)。血清总蛋白和白蛋白与预后(死亡)均成负相关(P>0.05)。结论脓毒症患者血清白蛋白水平常有变化,对预后(死亡)效果无明显影响。
Objective To investigate expression of early plasma albumin level in sepsis, and to reveal its clinical significance for judging short-term prognosis. Methods There were 112 sepsis patients, 49 cases of them with complicated septic shock as septic shock group and 63 cases without septic shock as sepsis group. Clinical data of all patients were taken from electronic medical record database. 24 h clinical parameters in patients were recorded （age, gender, disease, blood routine, procaleitonin, blood biochemistry and blood gas analysis） to calculate acute physiology and chronic health evaluation （APACHE ]I ） scores and 28 d survival condition. Comparison was made on serum albL[min level and related indexes between sepsis group and septic shock group, along with correlation between serum albumin level and short-term prognosis. Results The difference of onset time had statistical significance between the two groups （P〈0.05）. The sepsis group had higher serum total protein as （59.24±7.76） g/L than （54.01 ±9.31） g/L in the septic shock group （P〈0.05）, higher albumin as （31.36± 5.80） g/L than （26.08±7.20） g/L in the septic shock group （P〈0.05）, and higher prealbumin as （114.58 ±69.01） mg/L than （75.73±58.98） mg/L in the septic shock group （P〈0.05）. The differences of APACHE II scores, lactic acid and 28 d survival condition had statistical significance （P〈0.05）. Serum total protein and albumin were all negatively correlated with prognosis （death）（P〉0.05）. Conclusion Changes of serum albumin in sepsis patients show no obvious influence on prognosis （death）.
出处
《中国实用医药》
2016年第31期18-20,共3页
China Practical Medicine
