脓毒症患者出现肺损伤与微量白蛋白尿的相关性研究

发布时间：2018-01-03 04:03

本文关键词：脓毒症患者出现肺损伤与微量白蛋白尿的相关性研究　出处：《临床肺科杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨脓毒症患者出现肺损伤与微量白蛋白尿的相关性。方法研究98例脓毒症患者并于6 h内检测和计算其体内的尿白蛋白肌酐比值(urinealbumin ereatinine ratio.UACR)、肺血管通透性指数(Pulmonary vascular permeability index,PVPI);使用Picc0(pulse indicated cardiac output,Pi CC0)系统监测血管外肺水指数(Extravascular lung water index,EVLWI)和PVPI。(1)根据EVLWI是否增高,把患者分为EVLWI正常组与增高组,分别比较PVPI、氧合指数(oxygenation index,0I)和UACR的差异;(2)另外,根据是否需要机械通气把患者分为机械通气组和非机械通气组,分别比较EVLWI、PVPI和UACR之间的差异。(3)分析UACR与EVLWI、PVPI和0I的相关性。结果增高组的UACR(t=4.690,P0.001)、PVPI(t=26.512,P0.001)均高于正常组,OI(t=5.397,P0.001)低于正常组,而且他们差异均有统计学意义(P0.05)。其中UACR与EVLWI(r=0.809,t=14.48,P0.001)、PVPI(r=0.901,t=20.35,P0.001)呈现正相关的关系,但是与OI(r=-0.663,t=8.68,P0.001)呈现负相关的关系(P0.05)。需要机械通气患者的EVLWI(t=7.114,P0.001)、PVPI(t=15.378,P0.001)、UACR(t=5.018,P0.001)均高于非机械通气患者,并且差异均有统计学意义(P0.05)。结论对于部分脓毒症患者,可用尿白蛋白肌酐比值来预测肺水肿的形成和评估肺损伤的严重程度。
[Abstract]:Objective to investigate patients with sepsis associated lung injury and microalbuminuria. Methods 98 cases of patients with sepsis and urinary albumin creatinine ratio at 6 h in the detection and calculation of its in vivo (urinealbumin ereatinine ratio.UACR), pulmonary vascular permeability index (Pulmonary vascular permeability index, PVPI Picc0 indicated (pulse); cardiac output, Pi CC0) monitoring system of extravascular lung water index (Extravascular lung water index, EVLWI) and PVPI. (1) according to whether the EVLWI is increased, the patients were divided into normal group and EVLWI group increased compared to PVPI, oxygenation index (oxygenation, index, 0I) and UACR differences; (2) in addition. According to whether the required mechanical ventilation were divided into mechanical ventilation group and the non mechanical ventilation group were compared with EVLWI, the difference between PVPI and UACR. (3) analysis of UACR and EVLWI, the correlation between PVPI and 0I. The results of the UACR group increased (t= 4.690, P0.001), PVPI (t=26.512, P0.001) were higher than the normal group, OI (t=5.397, P0.001) is lower than the normal group, and their differences were statistically significant (P0.05). The UACR and EVLWI (r=0.809, t=14.48, P0.001), PVPI (r=0.901, t=20.35, P0.001) are positive correlation, but with OI (r=-0.663, t=8.68, P0.001) showed a negative correlation (P0.05). Mechanical ventilation in patients with EVLWI (t=7.114, P0.001), PVPI (t=15.378, P0.001), UACR (t=5.018, P0.001) were higher than the patients with mechanical ventilation, and the differences were statistically significant (P0.05). Conclusion for some patients with sepsis sepsis, available urine albumin creatinine ratio to predict the severity of lung edema formation and evaluation of lung injury.

【作者单位】：苏州市立医院本部重症医学科;
【分类号】：R459.7
【正文快照】： 脓毒症是重症医学科中较常见的疾病,其伴随着炎症的反应,导致一些器官周围的血管内皮细胞受损,使血管的通透性升高。肺组织损伤后易形成肺水肿,损伤太重的患者可能会出现急性呼吸窘迫综合征[1],需对患者进行机械通气[2]。医学上常用EVLWI[3]作为肺水肿的定量检测指标,而PVPI可

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