联合检测早期血清胆碱酯酶和过氧化脂质水平对老年严重脓毒症患者预后的评估作用

发布时间：2018-05-03 02:40

本文选题：脓毒症 + 胆碱酯酶　；参考：《广东医学》2017年06期

【摘要】：目的探讨老年严重脓毒症患者早期血清胆碱酯酶(S-Ch E)、过氧化脂质(LPO)的变化及意义。方法以193例严重脓毒症患者为观察组,以同期住院的脓毒症患者235例为对照组;根据治疗14 d的预后将观察组分为死亡组(n=104)与生存组(n=89);观察患者早期血清S-Ch E和LPO水平及变化情况;绘制受试者工作特征(ROC)曲线,分析血清S-Ch E和LPO水平与老年脓毒症MODS预后的关系。结果观察组血清S-Ch E低于对照组、LPO水平高于对照组,差异有统计学意义(P0.05);死亡组首次及治疗1、3 d的血清S-Ch E低于存活组、LPO水平高于存活组,差异有统计学意义(P0.05);观察组中低S-Ch E者死亡风险高于非低S-Ch E者,差异有统计学意义(P0.05);高LPO者死亡风险高于非高LPO者,差异有统计学意义(P0.05)。血清SCh E、LPO水平预测严重脓毒症死亡危险性的ROC曲线面积分别为0.912、0.828,敏感度分别为0.793、0.924,特异度分别为0.914、0.638,两者联合检测严重脓毒症死亡危险性的敏感度0.806,特异度0.935。结论 S-Ch E和LPO水平变化与严重脓毒症预后有关,两者联合应用有助于预测老年严重脓毒症死亡危险性。
[Abstract]:Objective to investigate the changes and significance of serum cholinesterase S-Ch EO and lipid peroxide (LPO) in elderly patients with severe sepsis. Methods 193 patients with severe sepsis were used as observation group and 235 patients with sepsis in the same period as control group. According to the prognosis of 14 days after treatment, the observation group was divided into two groups: the death group (n = 104) and the survival group (n = 89); the levels and changes of serum S-Ch E and LPO in the early stage of the patients were observed; To analyze the relationship between serum S-Ch E and LPO levels and MODS prognosis in elderly sepsis. Results the level of serum S-Ch E in the observation group was lower than that in the control group, the difference was statistically significant (P 0.05), and the level of serum S-Ch E in the death group was lower than that in the survival group at the first and third day after treatment, which was higher than that in the survival group. The risk of death in low S-Ch E group was higher than that in non low S-Ch E group (P 0 05), and the death risk in high LPO group was higher than that in non high LPO group (P 0 05). The area of ROC curve, the sensitivity and the specificity of the ROC curve for predicting the death risk of severe sepsis were 0.912 ~ 0.828 and 0.914 ~ 0.638, respectively. The sensitivity and specificity of the two methods were 0.806 and 0.935 respectively. Conclusion the changes of S-Ch E and LPO levels are related to the prognosis of severe sepsis.
【作者单位】：华北理工大学附属医院重症医学科;
【基金】：河北省医学科学研究重点课题(编号:ZL20140238)
【分类号】：R459.7

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