脓毒症早期血清白蛋白水平及其对短期预后的影响(1)
【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。
【关键词】 脓毒症；脓毒性休克； 血清白蛋白；短期预后
DOI：10.14163/j.cnki.11-5547/r.2016.31.008
【Abstract】 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， procalcitonin， blood biochemistry and blood gas analysis) to calculate acute physiology and chronic health evaluation (APACHE Ⅱ) scores and 28 d survival condition. Comparison was made on serum albumin 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).
【Key words】 Sepsis； Septic shock； Serum albumin； Short-term prognosis
膿毒症是创伤、烧伤、休克、感染等临床急危重患者的严重并发症之一， 也是诱发脓毒性休克、多器官功能障碍综合征的重要原因。脓毒症特别是脓毒性休克来势凶猛， 可以直接危及患者生命。血清白蛋白水平可以对患者的营养情况等予以很好的反映[1]， 脓毒症患者容易合并低蛋白血症。在脓毒症早期， 血清白蛋白水平在一定程度上反应机体状态及疾病严重程度。本研究通过观察脓毒症患者早期血清白蛋白水平变化， 分析其对患者预后的诊断价值。, http://www.100md.com(杨瑞红)
【关键词】 脓毒症；脓毒性休克； 血清白蛋白；短期预后
DOI：10.14163/j.cnki.11-5547/r.2016.31.008
【Abstract】 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， procalcitonin， blood biochemistry and blood gas analysis) to calculate acute physiology and chronic health evaluation (APACHE Ⅱ) scores and 28 d survival condition. Comparison was made on serum albumin 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).
【Key words】 Sepsis； Septic shock； Serum albumin； Short-term prognosis
膿毒症是创伤、烧伤、休克、感染等临床急危重患者的严重并发症之一， 也是诱发脓毒性休克、多器官功能障碍综合征的重要原因。脓毒症特别是脓毒性休克来势凶猛， 可以直接危及患者生命。血清白蛋白水平可以对患者的营养情况等予以很好的反映[1]， 脓毒症患者容易合并低蛋白血症。在脓毒症早期， 血清白蛋白水平在一定程度上反应机体状态及疾病严重程度。本研究通过观察脓毒症患者早期血清白蛋白水平变化， 分析其对患者预后的诊断价值。, http://www.100md.com(杨瑞红)