摘要
目的研究ICU老年脓毒症不同临床转归病人肾上腺皮质功能与急性生理与慢性健康(APACHEⅡ)评分的相关性。方法选取2014年3月至2017年3月期间我院收治的82例老年脓毒症病人作为研究对象,其中生存组63例,死亡组19例,比较2组病人不同时刻的APACHEⅡ评分、皮质醇(Cor)及促肾上腺皮质激素(ACTH)水平。按不同结局分层分析Cor及ACTH与APACHEⅡ评分的相关性。结果 2组病人不同时刻APACHEⅡ评分及Cor的差异均具有统计学意义(P<0.05)。与入院时相比,生存组住院7 d的APACHEⅡ、Cor及ACTH显著下降(P<0.05),死亡组住院7 d的APACHEⅡ、Cor及ACTH显著升高(P<0.05)。入院时Cor值、住院7 d后Cor变化值及ACTH变化值与入院时APACHEⅡ及住院7 d后的APACHEⅡ变化具有显著相关性(P<0.05)。结论老年脓毒症病人的肾上腺皮质功能与APACHEⅡ评分显著相关。
Objective To study the correlation between adrenal cortical function and APACHEⅡin elderly patients with sepsis in ICU. Methods From March 2014 to March 2017,82 patients were enrolled in this study,with 19 patients in death group and 63 patients in survival group. The APACHEⅡscore and the levels of cortisol（ Cor） and adrenocorticotrophic hormone（ ACTH） were compared between two groups. The correlation of Cor and ACTH with APACHE Ⅱ score was analyzed. Results The difference of APACHEⅡ score and Cor between the two groups were statistically significant at each time points（ P〈0. 05）. Compared with those at the admission of hospital,the levels of Cor,ACTH and APACHE Ⅱ 7 d after hospitalization decreased significantly in survival group（ P〈0. 05）,while increased significantly in death group（ P〈0. 05）. The level of Cor at the admission of hospital and Cor and ACTH7 d after hospitalization were significantly correlated with APACHEⅡat the admission of hospital and the variation of APACHE Ⅱ 7 d after hospitalization（ P〈0. 05） Conclusions Adrenal function is significantly correlated with APACHEⅡ score in elderly patients with sepsis.
作者
张敏
林怀印
孟肖
ZHANG Min;LIN Huai-yin;MENG Xiao(ICU,the Second People＇s Hospital of Hengshui,Hengshui 053000,Chin;Department of Oncology,Hengshui Hospital of Traditional Chinese Medicine,Hengshui 053000,China)
出处
《实用老年医学》
CAS
2018年第8期730-732,736,共4页
Practical Geriatrics
