摘要
目的探讨中性粒细胞百分比与高龄感染患者死亡率的相关性并评价其应用价值。方法以2013年1月至2017年6月空军军医大学西京医院老年病科住院治疗的191例高龄感染患者为研究对象,按30 d是否死亡将其分为死亡组(A组)和未死亡组(B组);研究两组患者中性粒细胞百分比(NP)>90%、临床相关指标、合并症与30 d死亡率的关系。采用SPSS 18.0统计软件进行数据分析,根据数据类型,组间比较采用t检验或χ2检验;单因素相关分析采用Spearman相关分析,多因素相关分析采用logistic回归法。结果两组年龄、性别、合并症、白细胞(WBC)差异无统计学意义(P>0.05);A组NP>90%患者比例、脓毒症比例、高敏C-反应蛋白(hs-CRP)、血乳酸、降钙素原(PCT)、急性生理与慢性健康评分(APACHE)Ⅱ、序贯性器官衰竭评估评分(SOFA)、机械通气及留置导尿比例较B组均显著升高,差异有统计学意义(P<0.05)。Spearman单因素相关分析显示,患者30 d死亡率与NP>90%(r=0.223)、APACHEⅡ评分(r=0.156)、SOFA评分(r=0.316)、血乳酸(r=0.453)、hs-CRP(r=0.656)、PCT(r=0.121)、脓毒症(r=0.286)、机械通气(r=0.461)、留置导尿比例(r=0.112)呈正相关。多因素logistic回归分析表明,NP>90%、血乳酸、hs-CRP、PCT、脓毒血症是影响30 d死亡率的独立危险因素。结论高龄感染患者NP>90%提示其30 d死亡的危险性升高,且比白细胞计数更能敏感反映感染的程度及病情。
ObjectiveTo investigate the correlation between the neutrophil percentage(NP)and mortality in the very old patients with infection,and evaluate its application value.MethodsA total191very old patients aged at(86.0±2.0)years with infection admitted in our department between January2013and June2017were recruited in this study.According to whether they died within30d,they were divided into dead group(group A,n=120)and survival group(group B,n=71).The relationship of NP>90%,clinical indicators and complications with30day mortality rate was analyzed.SPSS statistics18.0was used to perform the statistical analysis.Student’s t test or Chi square test was employed for different data types.Spearman correlation analysis was adopted for single factor correlation,and logistic regression for multivariate correlation analysis.ResultsThere were no significant differences in age,sex,incidence of complications and white blood cell count(WBC)between the2groups(P>0.05).The group A had obviously more patients with NP>90%,higher proportion of sepsis,higher levels of high sensitivity C reactive protein(hs CRP),blood lactic acid and procalcitonin(PCT),higher scores of acute physiology and chronic health evaluation(APACHE)Ⅱand sequential organ failure assessment(SOFA),and larger ratios of mechanical ventilation and indwelling catheterization when compared with the group B(P<0.05).Spearman univariate correlation analysis found that30day mortality rate was positively correlated with NP>90%(r=0.223),APACHEⅡscore(r=0.156),SOFA score(r=0.316),blood lactic acid(r=0.453),hs CRP(r=0.656),PCT(r=0.121),sepsis(r=0.286),mechanical ventilation(r=0.461),and indwelling catheterization(r=0.112).Multivariate logistic regression analysis showed that NP>90%,blood lactic acid,hs CRP,PCT and sepsis were independent risk factors for30day mortality rate.ConclusionFor the very old patients with infection,NP>90%indicates higher30day mortality rate.NP>90%is more sensitive to the extent and condition of infection than WBC.
作者
曹桂花
许荣
薛明涛
金凤钟
刘艳
葛伟
CAO Gui-Hua;XU Rong;XUE Ming-Tao;JIN Feng-Zhong;LIU Yan;GE Wei(Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an 710032, China)
出处
《中华老年多器官疾病杂志》
2018年第1期39-42,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
