脓毒症发热患者预后不良的早期预警指标研究

发布时间：2018-05-20 13:17

本文选题：发热 + 脓毒症　；参考：《中华医院感染学杂志》2016年20期

【摘要】：目的研究以发热为主诉的脓毒症患者临床资料及预后,寻找提示预后不良的早期预警指标。方法回顾性分析2014年1月-2016年1月以发热为主诉的81例脓毒症患者,根据预后分为预后良好组和预后不良组,其中预后良好组61例,预后不良组20例;比较两组间临床资料,并以预后为因变量,将组间差异指标进行logistic回归分析,以明确其与预后的关联。结果全部81例脓毒症患者中,预后不良组占24.69%,两组间年龄、性别、体质量指数等临床情况差异均无统计学意义;预后不良组中肺部感染显著高于预后良好组,预后不良组血红蛋白显著低于预后良好组,凝血酶时间显著长于预后良好组,差异均有统计学意义(P0.05);血乳酸含量明显高于预后良好组;logistic回归分析提示血红蛋白水平与不良预后负相关,血乳酸水平和凝血酶时间与不良预后正相关。结论以发热为主诉的脓毒症患者,就诊早期的血红蛋白、血乳酸和凝血酶时间可能对预后有一定预警作用,其中较低的血红蛋白水平,较高的血乳酸水平和较长的凝血酶时间均提示患者可能出现不良的预后情况。
[Abstract]:Objective to study the clinical data and prognosis of sepsis patients with fever, and to find early warning indicators for poor prognosis. Methods from January 2014 to January 2016, 81 patients with sepsis were divided into good prognosis group (61 cases) and poor prognosis group (20 cases) according to their prognosis. With the prognosis as dependent variable, the logistic regression analysis was carried out to determine the correlation between the different indexes and the prognosis. Results among the 81 patients with sepsis, the poor prognosis group was 24.69. There was no significant difference in age, sex, body mass index between the two groups, and the pulmonary infection in the poor prognosis group was significantly higher than that in the good prognosis group. Hemoglobin in poor prognosis group was significantly lower than that in good prognosis group, and thrombin time was significantly longer than that in good prognosis group. The results of logistic regression analysis showed that hemoglobin level was negatively correlated with poor prognosis, and blood lactate level and thrombin time were positively correlated with poor prognosis. Conclusion the hemoglobin, blood lactic acid and thrombin time in patients with sepsis with fever as the main complaint may have a certain early warning effect on prognosis, among which the lower hemoglobin level. Higher lactic acid levels and longer thrombin time all suggest poor prognosis.
【作者单位】：解放军总医院急诊科;
【基金】：国家科技重大专项(2013ZX1004805-003) 解放军总医院临床科研扶持基金(2012FC-TSYS3033)
【分类号】：R459.7

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