严重脓毒症患者临床特征及死亡预测因素分析

发布时间：2018-03-28 14:08

本文选题：严重脓毒症　切入点：临床特征　出处：《广东医学》2017年22期

【摘要】：目的分析严重脓毒症患者临床特征及死亡预测因素。方法选择135例脓毒症患者为研究对象,对比生存患者与死亡患者的临床特征和实验室检测结果,并采用logistic回归分析了解可预测患者死亡结局的因素。比较两组患者基础疾病情况、查尔森评分、实验室检查结果以及临床特征。结果 135例患者中病死29例,死亡率为21.48%;存活组67.90%的患者未合并基础疾病,明显高于死亡组的44.83%,差异有统计学意义(P0.05)。存活组基础疾病数量主要合并1~2种,而死亡组大多合并3种或4种基础疾病;存活组查尔森评分明显低于死亡组,差异有统计学意义(P0.05)。入院后,存活组血乳酸浓度与心率均明显低于死亡组,差异有统计学意义(P0.05)。存活组入院后体温、白细胞计数、降钙素原等指标与死亡组相比,差异均无统计学意义(P0.05)。Logistic回归显示基础疾病数量、查尔森评分、心率、血乳酸等是严重脓毒症患者死亡的独立预测因素。结论基础疾病数量、查尔森评分、血乳酸浓度、心率等可作为严重脓毒症患者有效的死亡预测因素,可用于临床综合判断预后,并于临床对患者危险进行有效分层,实现针对性治疗,降低病死率。
[Abstract]:Objective to analyze the clinical characteristics and death prediction factors of patients with severe sepsis. Methods 135 patients with sepsis were selected to compare the clinical characteristics and laboratory results of survival and death. Logistic regression analysis was used to find out the factors that could predict the death outcome of the patients, and to compare the basic disease, the Charlson score, the results of laboratory examination and clinical features between the two groups. Results 29 of the 135 patients died. The mortality rate was 21.48%, 67.90% of the patients in the survival group did not have basic diseases, which was significantly higher than that in the death group (44.83%), the difference was statistically significant (P 0.05). The number of basic diseases in the survival group was mainly associated with 12 kinds of basic diseases, while most of the patients in the death group were combined with 3 or 4 kinds of basic diseases. After admission, the blood lactate concentration and heart rate in the survival group were significantly lower than those in the death group, and the difference was statistically significant (P 0.05). The body temperature and white blood cell count in the survival group were significantly lower than those in the dead group. Compared with the death group, there was no significant difference between the procalcitonin and other indexes. Logistic regression showed that the number of basic diseases, Charson's score, heart rate and blood lactic acid were independent predictors of death in patients with severe sepsis. Charlson score, blood lactic acid concentration and heart rate can be used as effective predictors of death in patients with severe sepsis, and can be used to judge the prognosis comprehensively, and to effectively stratify the risk of patients in clinic, to achieve targeted treatment, and to reduce the mortality.
【作者单位】：遵义市第一人民医院重症医学科;
【基金】：贵州省科学技术基金项目(编号:黔科合J字[2014]2173号) 遵义市科技计划课题(编号:遵市科合社字[2015]05号)
【分类号】：R459.7

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